Venous malformation of lower limb with hypertrophy of limb, early terminalization of hair and hyperhidrosis

Vascular anomalies are the commonest developmental disorders. Venous malformations (VM) result due todysmorphogenesis in the development of veins. Most commonly these disorders are localized to skin and subcutaneoustissue. Deeper venous malformation may affect the underlying muscle, bone and joints. Early terminalization of hair andincreased sweating in VM plaque has been rarely reported. The present study deals with the case of a 15-year-old boywho had VM involving skin, subcutaneous tissue and bones with terminal hair and increased sweating over the plaque.Radiological examination showed bone hypertrophy with slow flow channels and phleboliths due to superficial and deepVM. He was treated with ethanol sclerotherapy.

Comparative Evaluation of Bioactive Glass in Treatment of Intra Osseous Periodontal Defects: A Clinical and Radiographic Study.

Background: The present clinical trial was designed to evaluate the effects of bioactive glass in treatment of periodontal intra-bony defects. Methods: 25 patients 23-55 years of age with intra-bony defects completed 1 year study. After completion of initial therapy, defects were randomly assigned to either a test or control procedure. Following flap reflection root planning and removal of chronic inflammatory tissue in both groups test defects were restored with bioactive glass, while open flap debridement was done in control sites. Muco-periosteal flaps were replaced sutured and periodontal dressing was used. Follow up was carried out weekly, 3 months 9 months and 1 year post surgery. Plaque score, sulcus bleeding score probing pocket depth were recorded at baseline, 3 months and 1 year. Standardized radiographs using RVG was taken at baseline, immediately post operatively and at 1 year. Results: Radiographs showed a significant increase in radiographic density and volume between defects treated with bioglass when compared with open flap debridement alone. Probing pocket depth, probing attachment level showed improvement in test and control site with greater trend to improvement in test site. Conclusion: It was concluded that bioglass is effective as an adjunct to conventional surgery in treatment of intra-bony defects.

Intraosseousschwannoma: A Case Report and Review

Bony schwannoma is a rare benign tumour derived from Schwann cells of nerve fibres in the bone. It accounts for less than 1% of bony benign tumour, and prone to occur in the sacrum and mandible, occurrence in scapula is very rare. Here we report a 50-year-old woman with the chief complaint of pain in the left scapula. Imaging examination showed a giant, irregular, swelling lesion with distinct border involving the left scapula, extending into the left shoulder glenoid and pressing the surrounding soft tissues. Needle biopsy showed that the tumour was composed of spindle cells with S-100 protein positive, mimicking a benign neurogenic tumour. Then a complete excision was performed by removing the tumour and the surrounding tissues including partial left shoulder glenoid. Histologically, Antoni type A areas were the predominant microscopic pattern with occasional alternation by Antoni type B areas. Immunohistochemistry found that the neoplastic cells were scatteredly positive for S-100 protein. All these features suggest a diagnosis of an intraosseousschwannoma of the left scapula. Follow-up of the patient for ten months found no recurrence or sign of other tumours following complete tumour resection without any adjuvant therapy. In conclusion, this case of giant intraosseousschwannoma of the scapula is a rare benign bony tumour, and its diagnosis combined with clinical, imaging and pre-operative needle biopsy is important to guide further therapy, and avoid overtreatment.

Imaging diagnosis of intra-osseous ganglia surrounding the ankle joint / 实用放射学杂志

Objective To investigate the imaging features of intra-osseous ganglia surrounding the ankle joints and their diagnostic value.Methods Imaging features of 40 cases of intra-osseous ganglia proved by the pathology from 1 982 to 2012 were analyzed ret-rospectively.33 cases underwent radiography,26 cases underwent computed tomography (CT)and 13 cases underwent magnetic resonance imaging (MRI).Results Intra-osseous ganglia were detected at talus in 23 cases,distal tibia in 1 5 cases (8 cases in pos-terior melleolus,6 cases in medial melloulus and 1 case in anterior part of distal tibia),and lateral malleolus in 1 case.Multiple in-tra-osseous ganglia was detected in 1 case,which located in both talus and posterior malleolus.29 cases were oval,monolocular os-teolytic lesions.1 1 cases were multilocular lesions with separation.All cases were observed with slightly sclerous edge.Articular surface disruptions were observed in 1 5 cases,and lesions were connected with the joint space.① Oval cystic translucent areas with sharp and sclerous edge adjacent to the ankle joint were observed in 34 lesions of 33 cases on radiograph.Cracks were noted on the articular surface of 12 lesions.② Round translucent areas with sharp and sclerous edge were observed in 26 isolated lesions on CT images.Cracks were noted on the articular surface of 14 lesions.③ 14 lesions of 13 cases showed low to moderate signal on T1 WI and high signal on T2 WI.Cracks were observed in 4 lesions adjacent to the ankle joint,and soft tissue swelling was noted in 6 le-sions.Conclusion Intra-osseous ganglia can be diagnosed accurately based on the typical imaging features and special locations.

Carcinoma primario intraóseo / Primary intra-osseous carcinoma

El carcinoma primario intraóseo (PIOC) es un tumor poco frecuente, definido como carcinoma escamoso que se desarrolla en huesos maxilares, no teniendo conexión inicial con mucosa ni piel adyacente. Es localmente agresivo, con una incidencia de metástasis en ganglios regionales del 28% y en pulmón del 5%, en el momento del diagnóstico. Su origen puede ser de novo o a partir de otros tumores odontogénicos. Los huesos maxilares son los únicos que tienen en su interior tejidos epiteliales, por lo cual esta neoplasia se localiza exclusivamente en este sitio, predominantemente en la mandíbula. Los criterios diagnósticos del PIOC incluyen: histopatología de carcinoma escamocelular, ausencia de compromiso de mucosa oral y senos paranasales, descartando metástasis de un sitio distante en base a estudios clínicos y métodos complementarios. El tratamiento de elección consiste, siempre que sea posible, en la exéresis con criterios oncológicos, y radio y/o quimioterapia adicional. Se requiere además, cirugía reconstructiva con injerto y/o prótesis con fines estéticos y funcionales. Presentamos el caso de un varón de 72 años, que consultó por molestias en maxilar inferior tres meses después de la extracción de un molar. Se efectuó biopsia por curetaje y luego se resecó el maxilar inferior con vaciamiento ganglionar. El estudio histopatológico mostró un carcinoma escamoso pobremente diferenciado, infiltrante en hueso maxilar, con hallazgos morfológicos que lo vinculaban a quiste odontogénico residual, y metástasis en 15 de 48 ganglios aislados. Se realizó radioterapia postquirúrgica, falleciendo a los 30 meses del diagnóstico por deterioro progresivo.

Primary intra-osseous carcinoma (PIOC) is a rare tumor, defined as squamous cell carcinoma that develops in the jaw bones, having no initial connection to adjacent skin or mucosa. It is locally aggressive, with metastases to regional lymph nodes, (28% of cases) and lung (5% of cases) at the time of diagnosis. Its origin may be di novo or from other odontogenic tumors. The maxillary bones have epithelial tissues; therefore this neoplasm is located exclusively on this site, predominantly in the jaw. PIOC diagnostic criteria are strict and include: squamous cell carcinoma histopathology, lack of commitment and sinus mucosa, ruling out the possibility of metastasis from a distant site with a thorough clinical study and complementary methods. The treatment is, whenever possible, oncologic resection, additional radio and / or chemotherapy. Reconstructive surgery with graft and / or prostheses for aesthetic and functional are also required. We report the case of a 72 years old man who consulted for sore jaw three months after molar extraction. Curettage biopsy was performed and then resected mandible with lymphadenectomy. Histopathological examination showed a poorly differentiated squamous cell carcinoma, infiltrating jawbone with morphological findings linking him to residual odontogenic cyst and metastatic lymph nodes in 15 of 48 isolates. Postoperative radiotherapy was performed, he died at 30 months of diagnosis by progressive deterioration.

Concomitant occurrence of canine transmigration and symmetrical agenesis of incisors – A case report.

Transmigration of mandibular canine is an unusual phenomenon characterized by movement of the impacted canine crossing the mandibular midline. Mandibular canine are rarely found impacted in a horizontal position in the mandible. Most of the time, this entity occurred as an isolated finding. However there are reports showing association of dentigerous cyst and a hyperdontia. The purpose of this report is to present a case of transmigrated canine associated with agenesis of mandibular both central incisors which is not reported previously.

Two Simple Tests for Adequate Needle Positioning in Vertebroplasty / 대한척추외과학회지

STUDY DESIGN: We analyzed the diagnostic values of two simple tests for adequate needle positioning in vertebroplasty. OBJECTIVES: We wanted to suggest performing the aspiration test and patency test, which can replace some of the roles of intraosseous venography (IOV) in vertebroplasty, and we also wanted to analyze the two tests' diagnostic values. SUMMARY OF LITERATURE REVIEW: Intra-osseous venography is an existing safety test for vertebroplasty, but it is less frequently performed nowadays because of its drawbacks. MATERIALS AND METHODS: The aspiration test is defined as positive if blood is easily aspirated through a vertebroplasty needle, and a positive aspiration test means that the needle tip is communicating with the venous system. This and IOV were carried out on a total of 114 sides of 61 vertebrae of 40 consecutive patients. Agreement between the two tests was evaluated with using Cohen's kappa coefficient, and the diagnostic values of the aspiration test, with using IOV as the gold standard, were also evaluated. The patency test is done in the intra-vertebral vacuum cleft cases. After bipedicular insertion of needles, saline is injected into one needle. If the saline gushes out of the other needle, the test is positive, and it means that both needles are inserted in the vacuum cleft. The patency test was performed in 25 vertebrae, and the positive rate and causes of the negative result were investigated. RESULTS: Cohen's kappa coefficient between the aspiration test and IOV was 0.88. The sensitivity of the aspiration test was 88%, the specificity was 99%, the positive predictive value was 97%, and the negative predictive value was 93%. The patency test was positive in 88% of the vacuum clefts. In all the positive cases, both needles were located within the vacuum cleft. In all the negative cases, one of the two needles was located outside the cleft. CONCLUSIONS: The aspiration test is a simple and reliable test that has high agreement with IOV. The patency test can be a better choice than IOV for the vacuum cleft cases because it does not leave contrast media in the clefts.

The Changes of the Intra-Osseous Venographic Findings of the Proximal Femur before and after Intertrochanteric Varus Osteotomy in Legg-Calve-Perthes' Disease: Comparision of Venographic Changes between Normal and Affected Hip / 대한정형외과학회잡지

In order to clarify the changes of the venous circulation in normal and affected hip with Legg-Ca1ve-Perthes' disease(L.C.P.D.) and to assess the effect of intertrochanteric varus osteotomy on the venous circulation around the proximal femur in L.C.P.D., intra-osseous venography(I.O.V.) was performed before osteotomy and also 8 weeks later when K-wires or staples used at the time of osteotomy were removed. Results obtained were as follows: 1. The material was consisted of 13 normal and 17 hips with L.C.P.D.. There were 14 boys and one girl, with a mean age of 6.1 years ranged from 5 to 9 years; in two patients the disease was bilateral. 2. When the hips with L.C.P.D. were divided into four groups by the method described by Catterall, three hips were included in group II, ten in III and four in IV. 3. In I.O.V. of the proximal femoral metaphysis on 13 normal hips, the opaque medium disappeard rapidly through the local venous system around the proximal femur, and no regurgitation into diaphysis were noted. But gluteal and medial circumflex vein in each one case was not visualized. 4. Of 17 hips with L.C.P.D., an I.O.V. was carried out before and after the intertrochanteric osteotomy. The ligamentum teres and gluteal vein appeared in only 4(24%) and 7 hips (41%) before and after osteotomy. And the lateral and medial circumflex vein visualized in 12(71%) and 15 hips before osteotomy and in 17 hips, both after osteotomy. The diaphyesal regurgitation in 35 % and trochanteric venous pooling of the opaque medium in 47%, indicating venous congestion on the trochanteric region of femur, disappeared after the osteotomy. But no significant differences in their age and group of L.C.P.D. were found. All of these findings suggest that the impaired venous system around the proximal femur and increased intra-osseous pressure on proximal femur may act as one of the important role in pathophysiology of the L.C.P.D., and the intertrochanteric osteotomy might have some positive effect for the normalization of venous circulation and intra-osseous pressure in L.C.P.D..

Intra-Osseous Venography in Patellofemoral Disorders: Clinical Significance / 대한정형외과학회잡지

We performed intra-osseous venography in 16 patients with chondromalacia patellae or patellofemoral osteoarthritis. Of 16 patients, eight patients had chondromalacia patellae and 6 patellofemoral osteoarthritis. Two patients with normal patellae who underwent meniscectomy were used as controls. The results obtained were as follows: 1. Dye congested in the normal patella was disappeared within 2 minutes after injection and extra-osseous drainage pattern disappeared within 1 minute. 2. in chondromaiacia patellae, large amount of dye was spread throughout the entire patella and remained till 10 minutes, while extra-osseous drainage pattern disappeared at about 5 minutes. 3. In patellefemoral osteoarthritis, venous engorgment in patella was similar to that of chondromalacia patellae and extra-osseous drainage pattern disappeared at about 10 minutes. Conclusively, authors thought the patella I.O.V. was one of the significant clinical methods to define the etiological factors of the various patellofemoral disorders such as patellofemoral osteoarthritis and chondromalacia patellae.