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

BACKGROUND: To study the effect of chloral hydrate oral premedication on sedation and arterial oxygen saturation in noncyanotic and cyanotic congenital heart disease children. METHODS: 18 noncyanotic congenital heart disease patients and 18 cyanotic congenital heart disease patients scheduled for cardiac surgery were premedicated orally with chloral hydrate 50 mg/kg. Arterial oxygen saturations were measured with pulse oximeter before and after oral premedication and sedation effects evaluated. RESULTS: In noncyanotic group oxygen saturation decreased from 98.7+/-0.95% (mean+/-?SD) before premedication to 97.8+/-1.15% after premedication with statistical significance but without meaning. 16 of the 18 patients (89%) were adequately sedated without airway obstructions. In cyanotic group oxygen saturation increased with statistical insignificance from 73.5+/-10.9% before premedication to 74.0+/-13.9% after premedication. 15 of the 18 patients(83%) were adequately sedated. Effects on oxygen saturation in cyanotic group patients were quite variable with 3 of the patients revealing more than 10% decrease in oxygen saturation. CONCLUSIONS: Chloral hydrate has a good sedative effects on congenital heart disease children but its effects on oxygen saturation were variable and close monitoring followed by oxygen administration is recommended in cyanotic heart patients.
Airway Obstruction ; Child* ; Chloral Hydrate* ; Heart ; Heart Defects, Congenital* ; Humans ; Hypnotics and Sedatives ; Oxygen* ; Premedication ; Thoracic Surgery

To determine the perinatal mortality and morbidity of fetuses with absent end-diastolic velocities (AEDV) of the umbilical artery in severe pre-eclampsia and eclampsia, the outcome of 5 fetuses with AEDV was compared with that of 35 fetuses with positive end-diastolic velocities (PEDV). The study population comprised 38 cases of severe pre-eclampsia and 2 cases of eclampsia with structurally normal singletons, who had had umbilical artery Doppler velocimetry weekly from admission to delivery. The Doppler velocimetry result was not used for the clinical management. Perinatal death and neonatal morbidity from both groups were further examined in gestational age category to control the influence of preterm births. The incidence of AEDV of the umbilical artery Doppler velocimetry in severe pre-eclampsia and eclampsia was 12.5% (5/40). The AEDV group had a significantly higher incidence than the PEDV group in terms of ceasarean section due to fetal distress (60% : 17%), Apgar score < 7 at 5 minutes (60% : 14%), perinatal death (25% : 0%) and assisted mechanical ventilation (67% : 9%) both at 32-36 weeks. Time intervals from the detection of AEDV to delivery of live neonates varied from the day to 15 days. In conclusion, AEDV in the umbilical artery might be of clinical value in routine surveillance of pregnancies complicated by severe pre-eclampsia and eclampsia, and predict hypoxic fetal condition which needs operative interventions before or during labor and mechanical ventilation after birth.
Apgar Score ; Cesarean Section ; Dystocia ; Eclampsia* ; Female ; Fetal Distress ; Fetus ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Maternal Death ; Mortality ; Parturition ; Parturition* ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Premature Birth ; Respiration, Artificial ; Rheology ; Trial of Labor ; Umbilical Arteries* ; Uterine Rupture

In spite of numerous clinical and patho-anatomical studies made in the past, there are still different opinions concerning the machanism of low back pain. We have focused attention on the posterior structures as an alternative source of low back pain with leg radiation, so we have studied and analyzed the effect of the injection of mixture methylprednisolone acetate suspension (20-40 mg) and local anesthetic (1% procaine, 1cc) into the posterior facet joint. In this paper, the records of 41 in-patients who have chiefly compalned of low back pain wlth leg radiation and have been treated at the Departmnt of Orthopedics, Han Yang University Hospital from May, 1979 to April, 1980 were studied. The following results are recognized by observing and analyzing their chief complalnts, physical examination, x-ray findings, the effect of facet block and the follow-up studies after facet block. 1. Low back pain with sciatica was 1.9 times more common in female than male, and frequently occured In 4th to 6th decades (75.7%). 2. The abnormal findings of plain x-rays were osteophyte (35.6%), marginal sclerosis (27.1%), narrowing of disc spce (18.6%), lumbarization (11.9%), spina bifida (3.4%), and tropism (3.4%). 3. The most frequent site of abnormal posterior facet joints was at the level between 4th and 5th lumbar vertebra (42.9%), and all were on lower lumber region. 4. The range of lumbar motion was decreased in the cases of abnormal posterior facet jolnt or degenerative changes, and it was especially more decreased in the combined cases. 5. The effect of facet block was as follows; In initial assessment, 29 of 41 cases (70.7%) showed complete rellef and one month later, 16 of 29 cases (55.2%) showed continuous rolief, 4 of 18 cases (22.2%) which were followed for 3 more months showed complete relief. 6. The effect of facet block according to pain character was as follows: 20 of 26 cases (76.9%) of numbness, 5 of 6 cases (83.3%) of dull pain and 4 of 8 cases (50.0%) of radlating pain were completely relleved and a case of burning pain was partially relleved.
Burns ; Female ; Follow-Up Studies ; Humans ; Hypesthesia ; Leg ; Low Back Pain ; Male ; Methylprednisolone ; Orthopedics ; Osteophyte ; Physical Examination ; Procaine ; Sciatica ; Sclerosis ; Spinal Dysraphism ; Spine ; Tropism ; Zygapophyseal Joint

BACKGROUND: Color Doppler echocardiography is sensitive in detecting mitral regurgitation and useful in quantitating its severity. The presence of an eccentric regurgitant jet suggests that regurgitation is caused by prolapsing or flail leaflet of mitral valve. Until recently the direction of regurgitant jet in mitral valve prolapse has been examined in a single(parasternal short axis view) or orthogonal plane using color Doppler echocardiography, and few in the apical rotation method of a transducer. The purpose of this study was to clarify the usefullness of the apical rotation method of a transducer in detection of the direction of mitral regurgitant jet and diagnosis of the sites of mitral valve prolapse. METHODS: Twenty four patients(8 men and 16 women, mean age:47.3+/-18.8 years) with mitral valve prolapse with eccentric regurgitant jet were examined by two-dimensional and color Doppler echocardiograply using conventional parasternal long and short axis views, and four apical longitudinal planes(four chamber, vertical, two chamber and transverse views) obtained by the apical retation method of a transducer. RESULTS: Thirty one regurgitant jets were detected in twenty four patients, eighteen patients had anterior, nine patints posterior, and three patients bi-leaflet(anterior and posterior) prolapse. In eighteen patients with anterior leaflet prolapse, ten had medial, eight had middle, three had lateral, and three had two portions(two, medial and middle; one, middle and lateral) prolapse. In nine patients with posterior leaflet prolapse, five had medial, three had middle, two had lateral, and one had two(medial and middle) scallop prolapse. CONCLUSION: Color Doppler echocardiography by the apical rotation method of transducer is useful in assessment of the site of prolapse in patients with mitral valve prolapse with eccentric regurgitation.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler, Color ; Female ; Humans ; Male ; Mitral Valve Insufficiency ; Mitral Valve Prolapse* ; Mitral Valve* ; Pectinidae ; Prolapse* ; Transducers*

No abstract available.
Child* ; Humans ; Nevus, Spindle Cell*