Fine needle aspiration (FNA) of soft tissue tumors (STT)

Purpose: The cytological findings of 52 STTs were reevaluated aiming to investigate the value of FNA in diagnosis of STTs. Methods: Fifty-two patients with a primary or reccurrent/metastatic STT underwent FNA in the preoperative investigation during the 2-year period. May-Grunvald-Giemsa, Papanicolaou and immunocytochemistry were applied to the smears. Results: Thirty-two cases were reported as malignant, whereas 12 were benign. Five cases were cytologically suspicious, 3 cases revealed unsufficient material. The most common malignant STT was small-round cell tumor. The overall rates for sensitivity and spesifity were 91% and 100%, respectively. Majority of the cases revealed sufficient material to decide whether the tumor was benign or malignant. Attempting to give the tumor grade led preoperative planning of the surgery; unnecessary surgery was avoided in metastatic/reccurrent tumors. Conclusion: A reliable diagnosis of STTs can be made with FNA, but close cooperation among the pathologist, surgeon and radiologist is mandatory

Congenital insensitivity to pain with anhidrosis - A case report

WOS: 000074189400015PubMed ID: 9651783We present a five-year-old girl with congenital insensitivity to pain with anhidrosis. A skeletal radiographic survey revealed several old fractures. Application of pilocarpine showed anhidrosis and nerve biopsy revealed a significant decrease in the number of myelinated and unmyelinated nerve fibres

Prenatal diagnosis of giant left ventricular diverticulum: Case report

PubMedID: 25286772The distinction between a ventricular aneurysm and diverticulum is difficult. The differences between these two are based on anatomical, histological, and functional criteria. We present a case of prenatal diagnosis of a giant left ventricular outpouching at 28 weeks gestation. During the postnatal period, the neonate underwent surgical correction for the outpouching. Histopathological examination reported the resected segment was a cardiac diverticulum. Our case indicates that differentiating between the two diagnoses during the intrauterine period is not always straightforward and possible. Histopathological examinations are sometimes necessary to make a precise differentiation. Treatment should be individualized depending on the clinical presentation. Mini-Abstract The distinction between a ventricular aneurysm and diverticulum is difficult. The differences between these two are based on anatomical, histological, and functional criteria. We present a case of prenatal diagnosis of a giant left ventricular outpouching at 28 weeks gestation. During the postnatal period, the neonate underwent surgical correction for the outpouching. Histopathological examination reported the resected segment was a cardiac diverticulum. Our case indicates that differentiating between the two diagnoses during the intrauterine period is not always straightforward and possible. Histopathological examinations are sometimes necessary to make a precise differentiation. Treatment should be individualized depending on the clinical presentation. © 2014, Wiley Periodicals, Inc

Transjugular approach to device closure of atrial septal defect: In a child with heterotaxia and interrupted inferior vena cava

PubMedID: 22719163In heterotaxia syndrome with left atrial isomerism, the distinguishing feature is interrupted inferior vena cava with azygos continuation. We report using a transjugular approach to device closure of an atrial septal defect in an 8-year-old boy with heterotaxia syndrome. We found that device closure of the child's atrial septal defect through a jugular venous approach was safe when an inferior vena cava approach was not possible. To our knowledge, ours is the first report of the use of internal jugular vein access to close an atrial septal defect in a child. © 2012 by the Texas Heart ® Institute, Houston

Subungual exostosis: Report of 7 cases

A subungual exostosis is a benign bone tumor found on the distal phalanx of a adjacent or beneath to the nail. This tumor is relatively uncommon. From 1981 through 1992 seven patients with subungual exostoses were seen in Cukurova University Orthopaedic clinic. Tumors were localized on great foe of six patients and fourth foe of one patient. All patients were treated by local excision and no patient had local recurrence

Congenital aorto-left atrial tunnel - An unusual communication: A case report

PubMedID: 17162395Congenital aortico-cameral communications are rarely seen. We present an asymptomatic patient in whom there was a congenital vascular communication rising from the aortic root and terminating in the left atrium. She had an atrial septal defect (ASD). The diagnosis was made with echocardiography and confirmed by aortography. She was treated by closing the tunnel and the ASD. The outcome was satisfactory in this extremely rare case of a congenital cardiac lesion. Coincidental diagnosis could be made during careful echocardiographic examination. © 2006 Forum Multimedia Publishing, LLC

The value of Tc-99m-tetrofosmin scintigraphy as am indicator of malignancy amongst bone and soft-tissue tumors

WOS: 000170528301061

The value of Tc-99m-tetrofosmin scintigraphy in the assessment of P-glycoprotein in patients with malignant bone and soft-tissue tumors

PubMedID: 14575377P-glycoprotein (Pgp) overexpression has been shown to be correlated with resistance to chemotherapy in patients with malignant bone and soft-tissue tumors. The aim of our study was to investigate the role of 99mTc-tetrofosmin as a functional imaging agent reflecting Pgp expression in these tumors. Methods: Twenty eight patients with various malignant bone and soft-tissue tumors were studied. Radionuclide angiography with 99mTc-tetrofosmin was done first and planar images were acquired at 15 min and 90 min postinjection. Vascular phase was evaluated visually on dynamic images, metabolic state was evaluated both visually and quantitatively on planar images. Quantitative analysis was performed by the calculation of tetrofosmin uptake in the lesion against background and percent washout rate (WR%) of the tracer. Immunohistochemical analysis of Pgp was performed on biopsy specimens and the degree of expression was graded from 0 to 3. Results: There was a positive correlation between the Pgp score and the washout rate of tetrofosmin (r = 0.73, p = 0.000). The mean washout rate of tetrofosmin from the lesions with Pgp expression (31.81 ± 6.72) was found to be significantly higher than those of without Pgp expression (21 ± 3.49) (p = 0.000). No statistically significant correlation was found between 15 min and 90 min uptake ratios (UR) of tetrofosmin and Pgp score (r = -0.10, p = 0.6 and r = -0.21, p = 0.2, respectively). When the cut-off value of 24.5 (according to ROC-analysis) for the washout rate was used to discriminate the lesions with and without Pgp expression, the test yielded a sensitivity value of 87.5% with a specificity of 100%. Conclusions: In malignant bone and soft-tissue tumors, 99mTc-tetrofosmin uptake were not related to Pgp overexpression. Pgp overexpression was found to be correlated with the washout rate of the tracer. 99mTc-tetrofosmin scintigraphy with washout analysis may not only be a useful method for evaluating Pgp overexpression but also its function

Serum free carnitine levels in epileptic children on valproic acid

3rd European Congress of Epileptology -- MAY 24-28, 1998 -- WARSAW, POLANDWOS: 000077228300006This study was carried out in a multipupose-based design to evaluate serum-free carnitine (SFC) levels in epileptic children. In a three-stage model, we sought to determine (a) SFC levels in epileptic patients receiving Valproic acid (WA) or other antiepileptic drugs for at least sir months, (b) on a longitudinal basis, WA-induced alterations in SFC levels in new cases given VPA therapy, and (c) whether decreased SFC levels were associated with detoriation in myocardial and respiratory functions and whether and to what extent use of L-carnitine supplementation would be justified to counter the presumable myocardial dysfunction. For determining SFC levels, all the samples were studied using enzymatic-calorimetric method Mean SFC level in each study group (monotherapy with VPA, polytherapy with VPA, and other antiepileptic group) showed significant depressed level from that of the control group (p 0.05), except for significantly increased posttreatment vital capacity (VC) (p< 0.05). Bat pretreatment VC levels were not lower than normal. In conclusion, patients presenting with decreased SFC levels following prolonged administration of WA or other antiepileptic drugs are not likely to experience some significant clinical problems as to merit L-carnitine supplementation.Int League Against Epileps

Tc-99m-tetrofosmin scintigraphy in musculoskeletal tumours: the relationship between P-glycoprotein expression and tetrofosmin uptake in malignant lesions

WOS: 000178641800009PubMed ID: 12352598The aims of this study were to assess the role of Tc-99m-tetrofosmin scintigraphy in the diagnosis of maligniant vs. benign musculoskeletal turnours and to determine the relationship between P-glycoprotein expression and tetrofosmin uptake in malignant lesions. Forty-six patients (32 malignant, 14 benign) with various musculoskeletal lesions were studied. Each patient underwent Tc-99m-methylene diphosphonate three-phase bone scanning initially. At least 2 days later, dynamic and static Tc-99m-tetrofosmin scans were obtained. The tetrofosmin scans were evaluated by visual and quantitative analysis. The count ratio of the lesion to the contralateral normal area (uptake ratio, UR) was calculated from the region of interest drawn on the tetrofosmin scan. The lesions were then resected by open biopsy to obtain a histopathological diagnosis. P-glycoprotein levels were determined immunohistochemically in 22 of 32 malignant lesions. A significant difference between the mean UR values of benign and malignant lesions was found (1.36 +/- 0.47 vs. 3.35 +/- 2.08, P = 0.000). Visual analysis showed an accuracy of 85%, and the accuracy of the quantitative analysis was 87% with the threshold level of UR as 1.76. When perfusion findings were added to the evaluation criteria, the accuracies of visual and quantitative analysis were increased to 87% and 89%, respectively. The relationship between the levels of P-glycoprotein and the UR values of tetrofosmin was not statistically significant (r = - 0.235, P = 0.2). In addition, the mean UR value of the patients with P-glycoprotein expression was not statistically different from that of the patients without P-glycoprotein expression (3.01 +/- 1.48 vs. 4.27 +/- 2.90, P = 0.297). In conclusion, visually significant tetrofosmin uptake and increased perfusion in a musculoskeletal lesion strongly suggest that the lesion is malignant (positive predictive value, 96%). P-glycoprotein expression was not found to be a major factor interfering with 30 min tetrofosmin uptake in a malignant musculoskeletal lesion. However, the relatively high false-negative rate among negative results (28%) limits the value of 99mTc-tetrofosmin scintigraphy as a single diagnostic tool in differentiating between benign and malignant musculoskeletal turnours. ((C) 2002 Lippincott Williams Wilkins)