A rare case of primary adult cardiac rhabdomyosarcoma with lower extremity metastasis.

Primary cardiac tumors are uncommon. Rhabdomyosarcomas are among the rarest type of cardiac sarcomas. Echocardiography, cardiac MRI, and computed tomography scan can help the diagnosis and presurgical management. In this article, we report a rare case of primary cardiac rhabdomyosarcoma originating from the mitral valve with left femoral metastasis in a patient in her 60s. The diagnosis was made using transesophageal echocardiography and cardiac MRI. A metastatic lesion was found in an extended PET scan in one of her clinical follow-ups due to her leg pain. Based on this report, we suggest that extending PET scan to the lower extremities could be helpful in the early diagnosis and treatment of remote metastases of cardiac rhabdomyosarcomas.

Magnetic Resonance Imaging of Nerve Tumors.

Nerve tumors are uncommon soft tissue neoplasms predominantly arising from peripheral nerve sheath and Schwann cells. We review the manifestations of benign peripheral nerve sheath tumors, concentrating on distinguishing imaging features of schwannomas versus neurofibromas with an emphasis on treatment implications. Nevertheless, there is often an overlap between the imaging presentation of these two conditions, making the accurate radiologic diagnosis challenging. Therefore, tissue sampling is often needed for a definitive histologic diagnosis. Treatment planning largely depends on symptoms, location of the lesion, and underlying risk factors. Three major syndromes, neurofibromatosis type 1, type 2, and schwannomatosis, predispose patients to peripheral nerve sheath tumors (PNSTs), with particular concern about the malignant subtype expression. In patients with suspected PNSTs, correlation of imaging findings with clinical findings and genetic tests is helpful for a more accurate diagnosis and disease management. Some imaging features on magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography can be helpful to differentiate malignant from benign subtypes.

Longitudinal Analysis of Quantitative Brain MRI in Astronauts Following Microgravity Exposure.

BACKGROUND AND PURPOSE: Assessment of the effects of microgravity on astronauts' brains using microstructural measures by utilizing quantitative MRI, before and after spaceflight would help understand the structural changes. METHODS: Quantitative MRI data sets in 19 astronauts were acquired before and after space missions. Both diffusion tensor metrics and volumetric measures were analyzed in the brain regions involved in the visual function. RESULTS: The fractional anisotropy was reduced in the right posterior thalamic radiations (P = .0009) and remained significant after a false discovery rate (FDR) correction (P = .03). A trend of increase in the mean diffusivities of different subregions of the occipital cortex on the right side, including calcarine, middle occipital, inferior occipital, and fusiform gyri, was noted and became insignificant after FDR correction. Similarly, there was a trend of cortical thinning involving the right occipital lobe and bilateral fusiform gyri, volume reduction of the left thalamus, and increase in lateral ventricular volume in the postflight scans. CONCLUSION: Gray and white matter alterations are detected by quantitative MRI before and after space flight. Our findings may be used to understand the neuroanatomical mechanisms of possible brain dysfunction or neuroplasticity in microgravity condition in the future studies.

Prophylactic Antibiotic Therapy in Contaminated Traumatic Wounds: Two Days versus Five Days Treatment.

INTRODUCTION: Emergency department manages several kinds of wounds including simple, non-bite traumatic wounds and lacerations. Prophylactic antibiotic therapy is one of pre-scribed treatment in these conditions. We aimed to compare the clinical efficacy of the two day regimen of prophylactic antimicrobial agents with the five day regimen in simple traumatic but highly contaminated wounds. METHODS: Between January 2010 and May 2010, patients presenting with simple traumatic wounds or lacerations in different parts of the body, highly contaminated with soil, debris or feces in emergency department of a referral educational hospital in Tehran (Rasul-Akram hospital), Iran, went for primary closure. All of the patients were provided prophylactic antibiotic, however, prescribed for one group (A) of patients for 2 days and other group (B) received for 5 days, according to the physician concerned. As these treatments were routine, we selected 70 patients from each group using table of random numbers. The patients were warned about the signs of infection including long-lasting erythema, purulent discharge and inflammation and were supposed to inform the concerned physician in any of such alarming situations. Oral Cephalexin 500 mg qid was prescribed for all patients enrolled for prophylaxis treatment. RESULTS: On follow-up 11 (8.2%) patients were found to develop sutured site infection (6 out of 70 (8.57%) in group A, and five out of 70 (7.14%) in group B (P=0.31)). There was no statistical difference between infection rates between men (8.6%) in comparison to women (6.25%) (P>0.05; CI=95%). CONCLUSION: Our study showed that 2-day prophylactic antibiotic therapy using Cephalexin is at least as effective as a 5-day regimen in relation to development of surgical site infection in patients with simple traumatic contaminated wounds or lacerations.