Ileal epithelioid leiomyosarcoma with omental and peritoneal seeding / 영남의대학술지

Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.

Ileal epithelioid leiomyosarcoma with omental and peritoneal seeding / 영남의대학술지

Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.

Percutaneous Transphyseal Intramedullary Kirschner Wire Fixation for Pediatric Diaphyseal Forearm Fractures

PURPOSE: Percutaneous pin fixation is commonly applied for pediatric diaphyseal forearm fractures. We analyzed the results of percutaneous transphyseal intramedullary K-wires fixation for pediatric forearm fractures and evaluated the safety of this procedure in terms of growth. MATERIALS AND METHODS: Thirty-six pediatric patients with forearm diaphyseal fractures treated with transphyseal intramedullary K-wire fixation were reviewed retrospectively. Authors analyzed size and number of fixed K-wires and evaluated postoperative complications, bone length discrepancy and any deformity at the last follow-up. We also evaluated range of motion of wrist and forearm as a functional result. RESULTS: The mean age was 9.5 years old and the average period of follow-up was 53 months (range: 23-85 months). Single wire was applied in each bone, and 1.6 mm sized K-wire was most commonly used for radius fractures and 1.1 mm K-wire for ulnar fractures. There was one superficial pin site infection which was healed by conservative treatment. There were no other complications such as premature epiphyseal closure, discrepancy of forearm length or any deformity. All patients showed no significant difference in range of motion compared to opposite side at the last follow-up. CONCLUSION: Percutaneous transphyseal intramedulaary K-wire fixation is one of the effective and safe operative treatment for pediatric forearm fractures without any deleterious effects on subsequent growth of radius and ulna.

Percutaneous Transphyseal Intramedullary Kirschner Wire Fixation for Pediatric Diaphyseal Forearm Fractures

PURPOSE: Percutaneous pin fixation is commonly applied for pediatric diaphyseal forearm fractures. We analyzed the results of percutaneous transphyseal intramedullary K-wires fixation for pediatric forearm fractures and evaluated the safety of this procedure in terms of growth. MATERIALS AND METHODS: Thirty-six pediatric patients with forearm diaphyseal fractures treated with transphyseal intramedullary K-wire fixation were reviewed retrospectively. Authors analyzed size and number of fixed K-wires and evaluated postoperative complications, bone length discrepancy and any deformity at the last follow-up. We also evaluated range of motion of wrist and forearm as a functional result. RESULTS: The mean age was 9.5 years old and the average period of follow-up was 53 months (range: 23-85 months). Single wire was applied in each bone, and 1.6 mm sized K-wire was most commonly used for radius fractures and 1.1 mm K-wire for ulnar fractures. There was one superficial pin site infection which was healed by conservative treatment. There were no other complications such as premature epiphyseal closure, discrepancy of forearm length or any deformity. All patients showed no significant difference in range of motion compared to opposite side at the last follow-up. CONCLUSION: Percutaneous transphyseal intramedulaary K-wire fixation is one of the effective and safe operative treatment for pediatric forearm fractures without any deleterious effects on subsequent growth of radius and ulna.

The Acute Calcific Prevertebral Tendinitis: Report of Two Cases

Acute calcific prevertebral tendinitis, which is also known as retropharyngeal calcific tendinitis and longus colli tendinitis, is an under-recognized cause of acute cervical pain produced by an inflammation of the longus colli muscle. The typical characteristics of this entity are calcifications at the superior insertion of the longus colli tendons at the C1-C2 level and fluid collection in the retropharyngeal space. The differential diagnosis includes a retropharyngeal abscess, infectious spondylitis or traumatic injury. Knowledge of the clinical and imaging findings can prevent a misdiagnosis and inappropriate attempts at surgical drainage.

Changes in the Hormone Receptors and the HER2 Expression in Primary and Recurrent Breast Cancer / 한국유방암학회지

PURPOSE: This study aimed at evaluating the pattern of changes in estrogen receptor (ER), progesterone receptor (PR) and the HER2 expression in primary and recurrent breast cancer. METHODS: In the study, we analyzed the changes of the ER and PR and the HER2 immunohistochemical expression to identify the patterns of changes and the predictive factors for the changes in 153 patients with primary and recurrent breast cancer between 1991 and 2005. RESULTS: There was a significant decrease in the positive rate of ER (50.3% to 38.6%, p<0.001), PR (43.8% to 26.8%, p=0.0095) and the HER2 (40.3% to 36.3%, p<0.001) expression in the primary breast cancers and recurrent breast cancers. The rate of triple negativity (ER/PR/HER2: all negative) was increased from 25.8% to 43.5% (p<0.001). Among 44 (28.6%) patients with changes in ER and ER status changed from positive to negative in 31 patients (20.3%) and negative to positive in 13 patients (8.3%) (p=0.007). For 58 patients (37.9%) who showed a change of the PR, the PR status changed from positive to negative in 42 patients (27.5%) and vice versa in 16 patients (10.4%) (p=0.0006). Twenty one patients (16.9%) changed from HER2 positive to HER2 negative and vice versa in 9 patients (7.3%) (p=0.029) among the 30 patients (24.2%) with changes in the HER2 expression. A multivariate analysis indicated that hormonal therapy was a significant factor that had an influence on the ER (odds ratio, 4.4) and PR (odds ratio, 2.6) changes. There were no significant differences in the survival rates according to the changes of the ER and PR, and the HER2 expression. CONCLUSION: The more common changes from positive to negative among the ER, PR, and HER2 indicated poor tumor biology of recurrent tumor. Therefore, the assessment of the ER, PR, and HER2 statuses is important for effectively treating recurrent breast cancer and especially those who have a previous history of hormonal therapy although survival benefit was not observed in this study.

Comparison of Radiologic and Clinical Results between Locking Compression Plate and Unlocked Plate in Proximal Humerus Fractures

PURPOSE: The purpose of this study is to compare the results of using a locking compression plate and an unlocked plate for treating proximal humeral fractures. MATERIALS AND METHODS: This study was based on 20 patients who underwent plate fixation for proximal humeral fractures out of the 87 patients with proximal humeral fractures and who were admitted from 2003 to 2007 in our hospital. Of the 20 patients, 10 were treated with a locking compression plate and the other 10 were treated with an unlocked plate. Each group was evaluated according to the humeral neck shaft angle, the period until bony union, the complications and the Constant score. The humeral neck shaft angle was based on plain x-rays taken immediately after the operation and at 6 months postoperatively. The Constant score was evaluated on the last visit to our clinic. RESULTS: There was no significant statistical difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. Yet, there were three cases of screw migration in the unlocked plate group. CONCLUSION: There was no significant difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. The locking compression plate is considered to achieve more effective fixation for proximal humerus fractures because there were less complications such as screw migration.