Myxofibroliposarcoma and tumor's characteristics

Myxofibroliposarcoma is myxoid tumor of soft tissue. To make a right diagnose we have to follow up a few criteria, patholocical ones . Most important is a pleomorphism with cytologic atipia at least 10%.They arise most in superficial subcutaneous tissue or in dermis. The exact difference between low grade MFLSa and high grade MFLSa is not distincitve. However, the recurrent low grade myxofibroliposarcoma is infiltrative and knows to be aggressive. So, we can find metastatic nodes in mesenteria, lungs, kidneys, pleura and bones and other distant organs. This kind of tumor is very often in lower extremities of elderly patients. Prognosis is different from case to case. Treatment is surgical, sometimes includes chemotherapy and radiation

Primary systemic amyloidosis

Background. Systemic amyloidosis is a rare disorder which usually occurs in aged persons and has a poor prognosis. Systemic amyloidosis can be primary, occasionally associated with multiple myeloma, or secondary, associated with another disease. Case report. We presented a 72-year-old male patient with periocular purpura ("racoon sign") and waxy papules, petechiae and ecchymoses on the neck and thoracic area. Purpuric macules were present also on the lips and tongue which was edematous (macroglossia). The skin lesions occurred two years earlier, the patient lost more than 15 kilograms of the body mass for less than a year. Immunoelectrophoresis of urine and serum demonstrated the presence of immunoglobulin light chains of the circulating monoclonal protein. Histopathological examination of skin lesions showed Congo red positive deposits in the derm. Cardiac evaluation revealed the signs of heart failure, and renal evaluation revealed nephrotic syndrome, with excessive protein lost. He was treated with oral melphalan and prednisolone, and died 7 days after starting the therapy due to heart failure. Conclusion. This patient considered as a rare case with systemic amyloidosis highlights the importance of histopathological and physical examination in any cases with periocular purpura, petechiae, ecchymoses and macroglossia

Indoor radon activity concentration measurement using charcoal canister

Active charcoal detectors are used for testing the concentration of radon in dwellings. The method of measurement is based on radon adsorption on coal and measurement of gamma radiation of radon daughters. Detectors used for the measurement were calibrated by 226Ra standard of known activity in the same geometry. The contributions to the final measurement uncertainty are identified, based on the equation for radon activity concentration calculation. The quantities that contribute to the combined measurement uncertainty in charcoal canister method for radon concentration screening were identified as uncertainties of: counting statistics, efficiency, calibration factor for radon adsorption rate, decay factor, time of exposure and measurement. Different methods for setting the region of interest for gamma spectrometry of canisters were discussed and evaluated. The obtained radon activity concentration and uncertainties do not depend on peak area determination method. Standard and background canisters are used for QA&QC, as well as for the calibration of the measurement equipment. Standard canister is a sealed canister with the same matrix and geometry as the canisters used for measurements, but with the known activity of radon. Background canister is a regular radon measurement canister, which has never been exposed. Carbon filters were unsealed and exposed in closed rooms for 2 to 3 days. Detectors were placed at distance of 1 m from the floor and the walls. Upon closing the detectors, the measurement was carried out after achieving the equilibrium between radon and its daughters (at least 3 hours) using NaI or HP Ge detector. Radon concentration as well as measurement uncertainty was calculated according to US EPA protocol 520/5-87-005. Considering the measured concentration values of 222Rn in dwelling units in Belgrade, as well as flaws of randomized sampling methods, the situation is not upsetting. Radon concentration in more than 80 % of apartments was lower than 200 Bq/m3, which is within normal limits for apartments. Radon concentration in 6 % of apartments and in 4 % of schools was higher than 400 Bq/m3 and intensive airing was recommended. For these dwellings additional measurements are required, followed by reparation of the facilities. © 2015 by Nova Science Publishers, Inc. All rights reserved

Uncertainty evaluation in radon concentration measurement using charcoal canister

Active charcoal detectors are used for testing the concentration of radon in dwellings. The method of measurement is based on radon adsorption on coal and measurement of gamma radiation of radon daughters. The contributions to the final measurement uncertainty are identified, based on the equation for radon activity concentration calculation. Different methods for setting the region of interest for gamma spectrometry of canisters were discussed and evaluated. The obtained radon activity concentration and uncertainties do not depend on peak area determination method. (C) 2013 Elsevier Ltd. All rights reserved

Reconstruction of Moderately and Severely Atrophic Scalp—A Multicentric Experience in Surgical Treatment of Patients Irradiated for Tinea Capitis in Childhood and Surgical Algorithm

Background and Objectives: Before the introduction of griseofluvin, the use of X-ray radiation was the treatment of choice for tinea capitis. More than half a century later various types of tumors have been found to be associated with childhood irradiation due to tinea capitis, most commonly cancers of the head and neck, as well as brain tumors. The often unusually aggressive and recurrent nature of these tumors necessitates the need for repeated surgeries, while the atrophic skin with an impaired vascular supply due to radiation often poses an additional challenge for defect reconstruction. We present our experience in the surgical treatment of such patients. Materials and Methods: This is a retrospective cohort study. In this study, 37 patients treated for acquired defects of the scalp with a history of irradiation therapy due to tinea capitis in childhood were included in this study, 24 male and 13 female patients. The mean age at the first appointment was 60.6 ± 7.8, with the youngest included patient being 46 and the oldest being 75 years old. Patients’ characteristics, surgical treatment, and complications were analyzed and a reconstructive algorithm was developed. Results: Local flaps were used for reconstruction in 34 patients, direct sutures were used in 10 patients and 20 patients received split-thickness skin grafts for coverage of both primary and secondary defects for reconstruction of flap donor sites. One regional flap and one dermal substitute covered by an autologous skin graft were also used for reconstruction. Complications occurred in 43.2% of patients and were significantly associated with the presence of comorbidities (p = 0.001), aseptic bone necrosis (p = 0.001), as well as skin atrophy in frontal, occipital, and parietal region (p = 0.001, p = 0.042 and p = 0.001, respectively). A significant correlation between major complications and moderate skin atrophy was found only in the parietal region (p = 0.026). Conclusions: Unfortunately, many protocols developed for scalp reconstruction are not applicable in the setting of severe or diffuse scalp skin atrophy associated with high tumor recurrence rate and radiation-induced vascular impairment, such as in tinea capitis patients in Serbia. An algorithm has been developed based on the authors’ experience in managing these patients