Nodular fasciitis is rare and benign fibroblastic proliferative disease which tends to be confused microscopically with spindle cell sarcoma. It is a distinctive lesion and a very important one because of its ability to simulate a malignant process. Histopathologically, nodular fasciitis can be grouped into three subtypes based on their relation with the fascia: subcutaneous, fascial, intramuscular. We report a case of nodular fasciitis misdiagnosed as Baker's cyst in a patient with rheumatoid arthritis.
Arthritis, Rheumatoid* ; Fascia ; Fasciitis* ; Fibroblasts ; Humans ; Popliteal Cyst* ; Sarcoma

PURPOSE: We prospectively conducted a multi-center, open-label, randomized phase II trial to compare the efficacy and safety of docetaxel plus cisplatin (DC) and etoposide plus cisplatin (EC) for treating advanced stage non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Seventy-eight previously untreated patients with locally advanced, recurrent or metastatic NSCLC were enrolled in this study. The patients received cisplatin 75 mg/m2 on day 1 and either docetaxel 75 mg/m2 on day 1 or etoposide 100 mg/m2 on days 1 to 3 in the DC or EC arm, respectively, every 3 weeks. RESULTS: The objective response rate was 39.4% (15/38) and 18.4% (7/38) (p=0.023) in the DC and EC arms, respectively. The median time to progression (TTP) was 5.9 and 2.7 months (p=0.119), and the overall survival was 12.1 and 8.7 months (p=0.168) in the DC and EC arms, respectively. The prognostic factors for longer survival were an earlier disease stage (stage III, p=0.0095), the responders to DC (p=0.0174) and the adenocarcinoma histology (p=0.0454). The grades 3 and 4 toxicities were similar in both arms, with more febrile neutropenia (7.9% vs. 0%) and fatigue (7.9% vs. 0%) being noted in the DC arm. CONCLUSION: DC offered a superior overall response rate than does EC, along with tolerable toxicity profiles, although the DC drug combination did not show significantly improved survival and TTP.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Etoposide* ; Fatigue ; Febrile Neutropenia ; Humans ; Prospective Studies

BACKGROUND: Rifampin is sometimes used in combination with other anti-staphylococcal agents to treat methicillin-resistant Staphylococcus aureus (MRSA) infections but few reports are available about the usefulness of rifampin against MRSA infections, especially in soft tissue and bone infections. Thus, we evaluated the efficacy of rifampin as switch therapy for soft tissue and bone infections caused by MRSA and assessed the risk factors for treatment failure. MATERIALS AND METHODS: We retrospectively studied 44 patients who had soft tissue and bone infections caused by MRSA and were treated with rifampin in combination or as monotherapy as switch therapy from January 2001 to September 2004. RESULTS: The mean age of the subjects was 50.2 years and the number of male and female were 34 and 10, respectively. Median duration of rifampin use was 32 days and 25% of the patients had artificial prostheses. Thirty one patients (79.5%, 31/39) were cured with parenteral glycopeptide followed by rifampin in combination or as monotherapy. Eight patients (8/39) recurred after the completion of treatment. The presence of hip prosthesis was the only significant risk factor (P= 0.027) in multivariate logistic regression test. Rifampin was tolerable in all cases. CONCLUSION: Rifampin as switch therapy for soft tissue and bone infection caused by MRSA was effective in 79.5% (31/39) of sujects. The treatment failure seems to be associated with unremovable infected prosthesis.
Female ; Hip Prosthesis ; Humans ; Logistic Models ; Male ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prostheses and Implants ; Retrospective Studies ; Rifampin* ; Risk Factors ; Treatment Failure

BACKGROUND: Rifampin is sometimes used in combination with other anti-staphylococcal agents to treat methicillin-resistant Staphylococcus aureus (MRSA) infections but few reports are available about the usefulness of rifampin against MRSA infections, especially in soft tissue and bone infections. Thus, we evaluated the efficacy of rifampin as switch therapy for soft tissue and bone infections caused by MRSA and assessed the risk factors for treatment failure. MATERIALS AND METHODS: We retrospectively studied 44 patients who had soft tissue and bone infections caused by MRSA and were treated with rifampin in combination or as monotherapy as switch therapy from January 2001 to September 2004. RESULTS: The mean age of the subjects was 50.2 years and the number of male and female were 34 and 10, respectively. Median duration of rifampin use was 32 days and 25% of the patients had artificial prostheses. Thirty one patients (79.5%, 31/39) were cured with parenteral glycopeptide followed by rifampin in combination or as monotherapy. Eight patients (8/39) recurred after the completion of treatment. The presence of hip prosthesis was the only significant risk factor (P= 0.027) in multivariate logistic regression test. Rifampin was tolerable in all cases. CONCLUSION: Rifampin as switch therapy for soft tissue and bone infection caused by MRSA was effective in 79.5% (31/39) of sujects. The treatment failure seems to be associated with unremovable infected prosthesis.
Female ; Hip Prosthesis ; Humans ; Logistic Models ; Male ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prostheses and Implants ; Retrospective Studies ; Rifampin* ; Risk Factors ; Treatment Failure

The mechanisms of high turnover bone loss induced by Cyclosporin A (CsA) are not clearly understood. Deficiencies in sex hormones result in high turnover osteoporosis, and not only androgen but also estrogen plays an important role in maintaining bone mass in men. To study whether or not there are any changes in the levels of sex hormones, aromatization, and the expression of estrogen receptors in CsA-induced osteoporosis, we treated 39 rats with vehicle, low-dose CsA (5 mg/kg) and high dose CsA (15 mg/kg) for 28 days, and measured sex hormone levels by radioimmunoassay. Aromatase activities in ROS cells and 3T3-L1 cells were determined by measuring the conversion rate of 3H-androstenedione into 3H-estrone. ER and ER mRNA were measured by competitive RT-PCR in collected marrow cells and ROS cells. The levels of free testosterone in the serum in low-dose CsA-treated rats were unchanged, but the levels were significantly decreased in those treated with high-dose CsA as previously reported. The levels of total estradiol in the serum were significantly increased in the low-dose CsA-treated group (5 mg/kg) and were comparable to levels of the control group in the high-dose CsA-treated group (15 mg/kg). CsA increased the conversion of 3H-androstenedione to 3H-estrone in ROS cells, but not in 3T3-L1 cells. Meanwhile, CsA treatment did not change the rates of ER or ER mRNA expression in ROS cells or in collected bone marrow cells. In conclusion, CsA treatment decreased the level of free testosterone in the serum, but did not decrease the level of serum estradiol by enhancing aromatization. High-turnover osteoporosis induced by clinical dosage CsA treatment may not be caused by lowering the levels of circulating estrogen or by decreasing the expression of estrogen receptors.
3T3 Cells ; Animal ; Aromatase/metabolism ; Bone Marrow Cells/metabolism ; Cell Line ; Cyclosporine/pharmacology* ; Cyclosporine/adverse effects ; Male ; Mice ; Osteoporosis/chemically induced ; Rats ; Rats, Sprague-Dawley ; Receptors, Estrogen/metabolism* ; Sex Hormones/metabolism* ; Sex Hormones/blood

PURPOSE: To evaluate the difference in radiologic features of rhabdoid tumor of the kidney (RTK) in children according to the location of the tumor within the kidney. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings of pathologically confirmed RTK in seven children (5 boys and 2 girls; age range, 6 months to 4 years 8 months; median, 18 months). All subjects underwent abdominal CT. We analyzed tumor location, size, and margin; renal hilar involvement, subcapsular hematoma, calcification, necrosis, and lymphadenopathy. RTK was classified according to the location of the tumor within the kidney: A tumor that mainly located in the central portion of the kidney with or without peripheral extension was described as type I, while one located at the periphery was type II. Imaging findings between the two types were compared. RESULTS: Tumor size varied from 3 cm to 12 cm. Tumor outlines were ill-defined in four cases but relatively well-defined in three. Four tumors (57 %) were type I. Hilar involvement was found in all four and a small subcapsular hematoma in one. Three tumors (43%) were type II, and in all three, large crescent-shaped subcapsular hematomas were found. CONCLUSION: Centrally located RTK showed hilar involvement with a small subcapsular hematoma, while in cases of peripherally located RTK, a large subcapsular hematoma was present. These findings may be helpful for the differential diagnosis of other pediatric renal tumors.
Child* ; Diagnosis, Differential ; Female ; Hematoma ; Humans ; Kidney* ; Lymphatic Diseases ; Necrosis ; Retrospective Studies ; Rhabdoid Tumor* ; Tomography, X-Ray Computed

PURPOSE: To evaluate the difference in radiologic features of rhabdoid tumor of the kidney (RTK) in children according to the location of the tumor within the kidney. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings of pathologically confirmed RTK in seven children (5 boys and 2 girls; age range, 6 months to 4 years 8 months; median, 18 months). All subjects underwent abdominal CT. We analyzed tumor location, size, and margin; renal hilar involvement, subcapsular hematoma, calcification, necrosis, and lymphadenopathy. RTK was classified according to the location of the tumor within the kidney: A tumor that mainly located in the central portion of the kidney with or without peripheral extension was described as type I, while one located at the periphery was type II. Imaging findings between the two types were compared. RESULTS: Tumor size varied from 3 cm to 12 cm. Tumor outlines were ill-defined in four cases but relatively well-defined in three. Four tumors (57 %) were type I. Hilar involvement was found in all four and a small subcapsular hematoma in one. Three tumors (43%) were type II, and in all three, large crescent-shaped subcapsular hematomas were found. CONCLUSION: Centrally located RTK showed hilar involvement with a small subcapsular hematoma, while in cases of peripherally located RTK, a large subcapsular hematoma was present. These findings may be helpful for the differential diagnosis of other pediatric renal tumors.
Child* ; Diagnosis, Differential ; Female ; Hematoma ; Humans ; Kidney* ; Lymphatic Diseases ; Necrosis ; Retrospective Studies ; Rhabdoid Tumor* ; Tomography, X-Ray Computed

Experinece in the management of 74 patients with delayed traumatic intracranial hemorrhage(DTICH) of 474 head injury from January 1996 to December 1996 is poresented with emphasis on the incidence, occurring time, risk factors and outcome. The incidence of DTICH was 15.6% of all hospitalized head-injury patients. After an injury, every patient had an immediate computerized tomography(CT) scan to diagnose intracranial pathology and then CT follow-up was carried out according to intial CT finding and reurological deficit. The lesion was almost occurred in patients with initial abnormal CT finding(85.1%). 82.4% of DTICH were noted within 72 hours after injury. The delayed epidural hematoma and intracerebral hemorrhage were almost noted in first 72 hours(>90%), but the delayed subdural hemorrhage was found after a time interval varying from 6 hours to 10 days. So we strongly recommend CT follow-up in 4-8hour, 24-72hour, and then 7th day after head injury, especially in patients with initial abnormal CT findings. The risk factor of the delayed lesion was not hypotension, hypoxia, and consciousness level, but age of patients and the initial CT finding. The development of DTICH was not heralded by neurological deterioration. The prognosis of DTICH was not worse than non-DTICH. The patient with delayed subdural hemorrhage was better than the patient with non-delayed lesion(including hemorrhage and normal CT finding).
Anoxia ; Cerebral Hemorrhage ; Consciousness ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Intracranial Hemorrhages* ; Pathology ; Prognosis ; Risk Factors

Adipose Tissue ; Cheek ; Cicatrix ; Humans ; Mouth ; Oroantral Fistula ; Skin ; Subcutaneous Fat ; Tissue Donors ; Tongue ; Transplants

PURPOSE: To evaluate the patterns of injuries and frequency of associated findings on MR imaging in patients with both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears; to compare the associated findings, as seen on MR imaging, in cases with both ACL and PCL tears with those with ACL or PCL tears. MATERIALS AND METHODS: Ten patients with combined ACL and PCL tears, 16 with ACL tears and 18 with PCL tears, all confirmed by arthroscopy or open surgery, were involved in this study. To identify the associated knee injuries, MR images were retrospectively evaluated. RESULTS: In ten patients with combined ACL and PCL tears, open surgery led to the identification of six complete ACL tears (60%), four partial ACL tears (40%), eight complete PCL tears (80%) and two partial PCL tears (20%). Injuries associated with these combined tears, and revealed by MR imaging, comprised six medial collateral ligament injuries (60%), six lateral collateral ligament injuries (60%), five medial meniscal injuries (50%), three lateral meniscal injuries (30%), nine bony injuries (90%), two posterior capsular injuries (20%), and three popliteus muscle injuries (30%). The frequency of popliteus muscle injury was significantly different (p<0.05, Fisher's exact test) between the group with both ACL and PCL tears and that with ACL or PCL tears. CONCLUSION: Associated findings in patients with combined ACL and PCL tears are more frequentthan in those with ACL or PCL tears. In cases involving combined ACL and PCL tears, associated findings-as seen on MR images-should thus be carefully examined.
Anterior Cruciate Ligament ; Arthroscopy ; Collateral Ligaments ; Humans ; Knee Injuries ; Lateral Ligament, Ankle ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament* ; Retrospective Studies