Subject(s)
Bone Neoplasms/diagnosis , Finger Phalanges , Glomus Tumor/diagnosis , Adult , Bone Neoplasms/pathology , Female , Glomus Tumor/pathology , Humans , ThumbABSTRACT
UNLABELLED: Pulmonary function testing remains part of the routine preoperative investigations in patients with pectus excavatum, although there is evidence that reduced exercise capacity is predominantly due to impaired cardiovascular performance rather than ventilatory limitation. AIM OF THE STUDY: To evaluate the change of pulmonary function in patients after completion (metal bar removal) of minimally invasive repair for pectus excavatum compared to the preoperative functional results. PATIENTS AND METHODS: All patients who underwent minimally invasive repair for pectus excavatum (MIRPE) between February 2000 and June 2006 and subsequently had their metal bars removed were examined. Pulmonary function tests were performed as part of the routine pre- and postoperative protocol. Vital capacity (VC), forced expiratory volume in one second (FEV1), total lung capacity (TLC), residual volume (RV) and maximal expiratory flow rate at 25 % (MEF25) were evaluated. In addition, comparisons were made between patients with a low (
Subject(s)
Forced Expiratory Flow Rates/physiology , Funnel Chest/surgery , Lung/physiopathology , Total Lung Capacity/physiology , Adolescent , Child , Female , Funnel Chest/physiopathology , Humans , Male , Postoperative Period , Retrospective Studies , Spirometry , Treatment OutcomeABSTRACT
Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia, EH/ALHE) is a rare benign angioproliferative lesion which typically occurs in the region of the head and neck. In the literature, occurence on the extremity is only rarely described. A case of multiple occurence of EH/ALHE in the skin of the toes and metatarsal bone with osteolysis is reported. Occurence on the extremity, superficial and deep affection and some "atypical" microscopic features may cause diagnostic dilemma. The key diagnostic features of EH/ALHE are vascular channels lined with epithelioid endothelial cells, surrounding layer of myopericytes, absence of atypia and mitotic activity and characteristic inflammation. Immunohistochemistry may be helpful in settling the diagnosis.
Subject(s)
Angiolymphoid Hyperplasia with Eosinophilia/pathology , Foot Diseases/pathology , Hemangioendothelioma, Epithelioid/pathology , Adult , Angiolymphoid Hyperplasia with Eosinophilia/diagnosis , Foot Diseases/diagnosis , Hemangioendothelioma, Epithelioid/diagnosis , Humans , MaleABSTRACT
PURPOSE: Minimally invasive repair of pectus excavatum (MIRPE) was first reported in 1998 by D. Nuss. This technique has gained wide acceptance during the last 4-5 years. In the meantime, some modifications of the technique have been introduced by different authors. Our retrospective study reports our own experience over the last 36 months and modifications introduced due to a number of complications. METHODS: From 3/2000 to 3/2003, 22 patients underwent MIRPE. Patients median age was 15.5 years (10.7 to 20.3 years). Standardised preoperative evaluation included 3D computerised tomography (CT) scan, pulmonary function tests, cardiac evaluation with electrocardiogram and echocardiography, and photo documentation. Indications for operation included at least two of the following: Haller CT index > 3.2, restrictive lung disease, cardiac compression, progression of the deformity and severe psychological alterations. RESULTS: In 22 patients (2 girls, 20 boys) undergoing MIRPE procedure, a single bar was used in 21 patients and two bars in one boy. Lateral stabilisers were fixed with non resorbable sutures on both sides. Overall, postoperative complications occurred in six patients (27.3%). In two patients (9.1%) a redo-procedure was necessary due to bar displacement. An additional median skin incision was performed in two patients to elevate the sternum. Pneumothorax or hematothorax in two patients resulted in routine use of a chest tube on both sides. Long-term favourable results were noted in all patients. CONCLUSIONS: The MIRPE procedure is an effective method with elegant cosmetic results. Modifications of the original method help to decrease the complication rate and to accelerate acquirement of expertise.
Subject(s)
Flail Chest/surgery , Imaging, Three-Dimensional , Minimally Invasive Surgical Procedures , Prosthesis Implantation , Thoracoscopy , Adolescent , Adult , Child , Child, Preschool , Flail Chest/diagnostic imaging , Follow-Up Studies , Humans , Outcome and Process Assessment, Health Care , Postoperative Complications/diagnostic imaging , Prosthesis Failure , Reoperation , Tomography, X-Ray ComputedSubject(s)
Down Syndrome/complications , Urethra/abnormalities , Adolescent , Adult , Child , Child, Preschool , Female , Humans , MaleABSTRACT
Pathogenesis of CRMO still remains unknown. Characteristic, but not pathognomonic for this syndrome are clinical course (age, sex, chronic recurrent, intermittent course), radiological findings (metaphyseal lesions), histology (chronic osteomyelitis without colliquation) and microbiological results (lack of pathogen, infectious agents). Favorable, self-limited long-term prognosis of CRMO has been assumed. Antibiotics provide no improvement. Course, severity and recurrency can be influenced positively by antiphlogistic substances, although this has not yet been proved. Whether surgical intervention beyond biopsies might cause improvement on the follow-up is unknown. Our experience (4 cases), and the literature demonstrate great clinical importance that unusual types of osteomyelitis (OM) can be within the differential diagnosis of multifocal osteolytic changes.