The outcomes and prognostic factors of patients with soft-tissue sarcoma.

The present study evaluates the outcomes and prognostic factors in patients with soft-tissue sarcomas of the extremities, trunk, head and neck region. A retrospective study of 104 patients who underwent treatment was conducted on 48 males and 56 females with a mean age of 44.5 years (range, 10-85 years). Seventy-eight patients had high-grade sarcomas and most tumors (89.5 percent) were located at the extremities. One hundred patients were treated by surgery and 51 patients were treated by both surgery and radiation therapy. With the median follow-up time of 24.5 months, local recurrence developed in 26 patients (25 percent) and distant metastasis developed in 29 patients (27.9 percent). The actuarial overall 3-year disease-specific survival rate were 74.2 percent. Multivariate statistical analysis revealed that positive surgical margin and occurrence of distant metastasis were significant predictors for overall survival. Positive surgical margin was the only factor that increased the risk of local recurrence and older age (> or = 60 years) was only the factor that increased the risk of distant metastasis. The results reaffirm the importance of the surgical margin where uncontrolled local disease affects the risk of local failure and disease-specific survival. Occurrence of distant metastasis is associated with older age (> or = 60 years) and decreases disease-specific survival of the patients.

Liver abscess in polycystic liver disease.

A case of an elderly female whose clinical manifestations were atypical in view of physiologic aging changes and multiple pathology commonly found in the geriatric group. The liver abscess had presented clinically and radiologically like a hepatic malignancy and pus was obtained during the process of liver biopsy. Even though anchovy-like pus suggested amebic in origin, the microscopic exam showed numerous polymorphonuclear leucocyte and the culture both from the blood and pus grew Klebsiella spp. as well as the study for E. histolytica antibody was also negative. Pyogenic liver abscess was the working diagnosis and indicated for surgical drainage. Adult polycystic liver disease was found intraoperatively and the liver pathology did reveal the presence of many amebae in the cavity of the right lobe of the liver. After the administration of ceftriaxone and metronidazole as well as the surgical drainage, the patient recovered uneventfully within sixteen days of admission.

Efficacy of DESMANOL® for surgical hand scrub.

The comparative study of Desmanolฎ and Hibiscrubฎ was carried out in order to test the efficacies of eliminating microorganisms from surgeons’ hands. Thirty surgical residents of Siriraj Hospital were enrolled in the study. Each subject’s hands and forearms were scrubbed with Desmanol and Hibiscrub on different occasions few days apart by random sequence. Prior to each scrubbing, the hand and forearm were cultured quantitatively by cotton swab technique. The culture was repeated after scrubbing. The coagulase negative staphylococci, micrococci and bacillus were found in almost all the subjects’ hands before scrubbing with both solutions at the quantity of 104 cfu. The other organisms cultured from 10 to 20% of subjects’ hands were S. aureus and gram negative bacilli at 102 to 103 cfu. Seventy percent of the subjects’ hands in both groups had negative culture after scrubbing. The organisms cultured from 30% of the subjects were coagulase negative staphylococci, micrococci and bacillus. However, the colony counts of these organisms were 100-fold decrease from those before scrubbing. No strains of S. aureus or gram negative bacilli were cultured after scrubbing.