Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

Fibrous histiocytomas are characterized by a variable combination of cells with fibroblastic and histiocytic features. They exhibit a distinctive but inconstant cellular arrangement referred to as a storiform or cartwheel pattern. Considerable corfusion has enveloped these tumors as a result of their various terminology-fibrous histiocytoma, dermatofibroma, sclerosing hemangioma, fibroxanthoma, subepidermal nodular fibrosis, xanthogranuloma, giant cell tumor of tendon sheath. A histologically benign but locally infiltrating, 15 * 20cm sized, fibrous histiocytoma was found in the posterior aspect of left thigh of a 17-year-old man. The tumor was incompletely excised due to adhesion of the tumor mass to sciatic nerve and then radiation therpy was combined, Histogenesis and prognostic aspects of the tumor are discussed.
Adolescent ; Fibroblasts ; Fibrosis ; Giant Cell Tumors ; Histiocytoma ; Histiocytoma, Benign Fibrous* ; Humans ; Sciatic Nerve ; Tendons ; Thigh

Mobility shifts in non-denatured gel electrophoresis of PCR-amplified Rif' region in each of fifteen different mutants of M. tuberculosis were discerned by single strand conformation polymorphism (SSCP) analysis. The findings of mobility differences between rifampin-resistant and susceptible strains showed an excellent agreement with data obtained by traditional susceptibility test. SSCP-PCR seemed to replace the cultivation method of susceptibility test that was known to be time-consuming, labor wasting, and skeptical in quality control. After screening of rpoB gene mutation by SSCP-PCR, detection of specific sequence changes in the region of rpoB gene was attempted through the procedures of PCR-amplification, cloning of PCR-products using pGEM-T vector and DNA thermocycling sequencing. Fifteen different types of mutations were identified among fifty strains of rifampin-resistant strains while five rifampin-susceptible control strains showed no sequence changes of rpoB gene as well as reference strain H37rv. Most mutation appeared to be a point mutation due to substitution or deletion except seven mutants showing somewhat complex mutation. Each of mut#ated loci inclined to clustering within a region of eighteen amino acids involving eight codons. The most common mutation of Ser425 shared among twenty-nine mutants and followed by eleven mutants of His420. Several mutants alleles identified in this study appeared to be dissimilar to those of previous reports.
Alleles ; Amino Acid Substitution* ; Amino Acids ; Clone Cells ; Cloning, Organism ; Codon ; DNA ; Electrophoresis ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Point Mutation ; Quality Control ; Rifampin* ; Tuberculosis

Purpose: Sarcopenia is a well-established prognostic factor for the clinical outcomes of adult patients with cancer and chronic diseases and correlates with increased intensive care unit admissions and prolonged hospital stays. However, research on sarcopenia in children is limited due to its undefined criteria and a lack of studies exploring its impact on clinical outcomes.Current concept: The challenges in pediatric sarcopenia research include the absence of standardized body composition methods to quantify muscle mass and muscular function, as well as inconsistencies in definitions.Additionally, there is a lack of age- and gender-specific normative data, particularly for young children and infants. Most studies also lack assessments of muscle function, which can lead to bias and misclassification of sarcopenia. The field is further hindered by poor study quality, limited outcome-focused research, and a dearth of longitudinal data.While some studies suggest that various diseases can affect children’s lean muscle mass, few have linked changes in muscle mass to clinical outcomes. Conclusion The existing literature on pediatric sarcopenia and its relationship with medical and surgical outcomes is sparse and indicates poorer outcomes associated with sarcopenia. Although extensive research has established a link between sarcopenia and adverse outcomes in adults, information on its impact in pediatric populations remains scarce. Further studies are needed to elucidate the association between muscle mass and outcomes in pediatric surgical patients.

PURPOSE: Results of 181 percutaneous needle aspiration biopsies performed with an 18-gauge needle during a period of 3 years were analyzed to determine efficacy and safety of the procedure. MATERIALS AND METHODS: Biposies were performed in patients that could not be diagnosed by bronchoscopy or sputum cytology. The biopsy procedure with 18-gauge Crown needle was guided by fiuoroscopy. The biopsy specimen placed in 10% formalin solution were histologically confirmed. RESULTS: In 160 patients(89%), the positive diagnosis was made by percutaneous needle aspiration biopsy. There were 153 lung lesions(120 malignant and 33 benign lesions) and 7 mediastinal lesions. the diagnostic accuracy of malignant and benign disease was 91% and 80% respectively. Complications included pneumothorax(n=11) and hemothorax(n=l):six of them required treatment with chest tube and the remainder showed spontaneous resporption. CONCLUSION: PCNB with an 18-gauge needle provided a reliable, relatively safe diagnostic tool to establish the diagnosis of both malignant and benign chest lesions.
Biopsy ; Biopsy, Needle* ; Bronchoscopy ; Chest Tubes ; Crowns ; Diagnosis ; Formaldehyde ; Humans ; Lung ; Needles* ; Sputum ; Thorax*

PURPOSE: Results of 181 percutaneous needle aspiration biopsies performed with an 18-gauge needle during a period of 3 years were analyzed to determine efficacy and safety of the procedure. MATERIALS AND METHODS: Biposies were performed in patients that could not be diagnosed by bronchoscopy or sputum cytology. The biopsy procedure with 18-gauge Crown needle was guided by fiuoroscopy. The biopsy specimen placed in 10% formalin solution were histologically confirmed. RESULTS: In 160 patients(89%), the positive diagnosis was made by percutaneous needle aspiration biopsy. There were 153 lung lesions(120 malignant and 33 benign lesions) and 7 mediastinal lesions. the diagnostic accuracy of malignant and benign disease was 91% and 80% respectively. Complications included pneumothorax(n=11) and hemothorax(n=l):six of them required treatment with chest tube and the remainder showed spontaneous resporption. CONCLUSION: PCNB with an 18-gauge needle provided a reliable, relatively safe diagnostic tool to establish the diagnosis of both malignant and benign chest lesions.
Biopsy ; Biopsy, Needle* ; Bronchoscopy ; Chest Tubes ; Crowns ; Diagnosis ; Formaldehyde ; Humans ; Lung ; Needles* ; Sputum ; Thorax*

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

No abstract available.
Carcinoma, Basal Cell ; Nose

BACKGROUND: PTEN is a novel tumor suppressor gene located at chromosome 10q23.3. Loss of PTEN function has been implicated in the progression of several types of cancer. Angiogenesis is a critical factor in tumor growth and metastasis. We investigated PTEN expression in invasive breast cancers and described its role in the regulation of angiogenesis related to vascular endothelial growth factor (VEGF). METHODS: Forty-five, surgically resected, formalin-fixed and paraffin embedded breast cancer tissue samples were analyzed for PTEN and VEGF expressions by immunohistochemistry and for microvessel density (MVD) by CD34 immunostaining. RESULTS: Loss of PTEN expression was found in 35.6% (16/45) of the breast cancer tissues, all of which showed positive VEGF expression. Among 29 cases with normal PTEN expression, 15 (51.7%) were VEGF positive. MVD was significantly higher in tumors with a loss of PTEN expression than in those with normal PTEN expression. CONCLUSION: A loss of PTEN expression might increase the VEGF-related angiogenesis in breast cancer. There was no correlation between PTEN expression and clinicopathologic parameters. Detection of the loss of PTEN expression may serve as a useful biologic marker for progression in invasive breast cancer.
Biomarkers ; Breast Neoplasms* ; Breast* ; Genes, Tumor Suppressor* ; Immunohistochemistry ; Microvessels ; Neoplasm Metastasis ; Paraffin ; Vascular Endothelial Growth Factor A

BACKGROUND: In ambulatory surgery, which is of short duration, anesthesiologists often do not use a muscle relaxant, or any other induction technique which could facilitate muscle relaxation for endotracheal intubation.Incomplete muscle relaxation, however, results in vocal cord movement and the possibility of damage to the vocal cords and adjacent structure.The aim of this study was to evaluate the macroscopic sequelae of intubation on vocal cord and laryngeal structure and assess postoperative sore throat or hoarseness. METHODS: 100 patients with class I or II ASA physical status were enrolled in this study.It was divided into two groups, Group C (conventional intubation dose of rocuronium; 0.6 mg/kg) and group L (low intubation dose 0.45 mg/kg).Anesthesia was induced with 10microgram/kg of alfentanil and 2.0 mg/kg of propofol i.v.Intubation was performed 90 second after rocuronium injection and the intubation condition was checked.Macroscopic sequelae ofthe laryngeal structure were evaluated using a flexible fiberoptic bronchoscope. After completion of surgery, the patient was asked to report sore throat or hoarseness. RESULTS: Macroscopic sequelae, such as erythema or hemorrhage, were statistically different between the two groups.There were no cases of minimal hemorrhage of either vocal cords or of the arryepiglottic folds in group C whereas there were two cases in group L.There was no statistical difference in incidence and severityof sore throat or hoarseness between the two groups. CONCLUSIONS: Although there were more macroscopic effects in the vocal cords and aryepiglottic folds, a low intubation dose of rocuronium can be used during surgery of short duration without fear of any significant sore throat or hoarseness after surgery.
Alfentanil ; Ambulatory Surgical Procedures ; Androstanols ; Bronchoscopes ; Erythema ; Hemorrhage ; Hoarseness ; Humans ; Incidence ; Intubation ; Muscle Relaxation ; Muscles ; Pharyngitis ; Propofol ; Vocal Cords