Radiological findings in 31 patients with chondroblastoma in tubular and non-tubular bones.

INTRODUCTION: This study aimed to evaluate radiological findings in patients with chondroblastoma (CB) in tubular and non-tubular bones (NTBs). METHODS: We retrospectively reviewed the medical records of patients with CB. Data collected included patients' gender and age, type, size and location of bone involved, and imaging findings regarding border, lobulation, calcification, trabeculation, cortical expansion and destruction, periosteal reaction, soft tissue component and fractures. Magnetic resonance imaging and/or multidetector computed tomography were used to determine the presence of any internal cystic space or secondary aneurysmal bone cyst that may have affected the radiological appearance of CB. RESULTS: All 31 lesions (18 tubular bones, 13 NTBs) exhibited geographic bone destruction and did not involve the adjacent joints. Univariate analysis showed that NTB lesions were found in older patients and were associated with thin trabeculation (p < 0.01) and well-defined margins (p < 0.05), whereas tubular bone lesions correlated with thick trabeculation and partially ill-defined margins. On multivariate analysis, age and type of bone involvement were significantly correlated. An increase in age by one year reduced the risk of having tubular bone involvement by about 27% when compared with NTBs (p = 0.011). Thin trabeculation was also significantly correlated with NTB lesions. CONCLUSION: Age was the most significant parameter, as increased age was found to reduce the risk of tubular bone involvement. Patients with NTB lesions were significantly older than those with tubular bone lesions. Based on imaging alone, thin trabeculation showed significant correlation with CB occurring in NTBs on both univariate and multivariate analyses.

Job satisfaction and organizational citizenship behavior of personnel at one university hospital in Thailand.

OBJECTIVE: To investigate the relationship between job satisfaction and Organizational Citizenship Behavior (OCB) of the personnel at one university hospital in Thailand. MATERIAL AND METHOD: This cross-sectional descriptive study was conducted on 296 respondents who worked in the Office of the Dean, 13 departments and 2 Offices of Research Center and Office of Community Medicine Center. All of them were personnel in one university hospital in Thailand. The Organizational Citizenship Behavior Questionnaire of Niehoff and Moorman using the five dimensions scale developed by Podsakoff and Mackenzie and Job Descriptive Index (JDI) were used for assessing job satisfaction. For inferential statistics, Pearson's product moment correlation coefficient was used for correlation. RESULTS: The percentage mean score of job satisfaction was 58.67 and subscale of job satisfaction was found that satisfaction with supervision held the highest of the mean score, while satisfaction with pay and promotion had the lowest and low of the mean score. The mean score of OCB was high and the facets of OCB was found that conscientiousness had the highest mean score and sportsmanship had the lowest. By using Pearson's Product Moment Correlation Coefficient to analyze the relationships between satisfaction and OCB, it showed that there were statistically significant low positive correlations between job satisfaction and OCB (r = 0.173, p < 0.01). CONCLUSION: The one university hospital executives should promote the pay, promotion and supervision factors which encourage personnel to be satisfied and demonstrate their OCB as their reciprocal reaction.

Emergency ultrasonography in patients with clinically suspected soft tissue infection of the legs.

INTRODUCTION: We aimed to retrospectively review the ultrasonography (US) findings of patients with clinically suspected soft tissue infection of the legs and to determine whether there is a correlation between US diagnosis and further clinical management. METHODS: We reviewed the US findings of consecutive patients with clinically suspected soft tissue infection of the legs who were referred for emergency US during a consecutive two-year period. The indications for US were recorded and the findings evaluated. The effect of the US findings on further clinical management (medication alone versus medication with surgical intervention [SI]) was reviewed. RESULTS: A total of 51 legs from 38 patients were enrolled in the study. The most common indication for US was to rule out necrotising fasciitis (35.3%). The most frequent US diagnosis was isolated cellulitis (21.6%). Both groups of patients (with and without abscess) were treated with medication with or without SI. There was no statistically significant correlation between the presence or absence of abscess and further clinical management (p = 0.216), between the size (length and thickness) of the abscess and the type of SI (p = 0.687 and 0.243, respectively) CONCLUSION: In our study, the most frequent US diagnosis was isolated cellulitis, and we found no significant correlation between US findings and clinical management (medication or SI). Our results should encourage sonologists to evaluate in detail patients with clinically suspected soft tissue infection of the legs and to provide information regarding each layer of tissue studied.

Asymptomatic Paget's bone disease in ethnic Thais: a series of four case reports and a review of the literature.

Paget's bone disease is quite common in some parts of Europe and countries inhabited by European emigrants, but it is rare in Asia. There have been only 13 reported cases in Southeast Asia, including one reported case from Thailand. Half of the previously reported cases had bone symptoms and the other half were asymptomatic, but were incidentally discovered when patients were being investigated for other medical problems. Here are reported cases of four asymptomatic patients who presented elevation of serum alkaline phosphatase during routine annual medical checkups. All patients were of Chinese descent and all cases were proven by biopsy. Based on this experience, we are of the opinion that a substantial number of unrecognized cases of Paget's disease exist among ethnic Thais. We feel that they would be revealed if clinicians were alerted of its presence and if they included it as a possible diagnosis together with metastasis and osteoporosis when examining bone lesions or when results for elevated serum alkaline phosphatase are detected during routine checkups. We also anticipate that a higher prevalence of this disease may occur in future Thai generations due to the addition of offspring from Asian-European intermarriages to offspring of Chinese descent in the ethnic Thai population.

Dynamic contrasted MR imaging in differentiation of recurrent malignant soft tissue tumor from posttreatment changes.

OBJECTIVE: To investigate dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in term of differentiation recurrent malignant soft tissue tumor (MSTT) from post-treatment changes. MATERIAL AND METHOD: DCE-MRI was performed in consecutive patients in two-year periods to differentiate recurrent MSTT from post-treatment (surgery radiotherapy chemotherapy) changes. The steepest slope (SS) ratio between the artery and the lesion, sensitivity, and specificity were calculated. RESULTS: Thirty-five DCE-MRI studies were performed in 30 patients, which included 14 males and 16 females with an age range from 12 to 71 years (median 45.81 year). Thirteen were with recurrence and 22 were with post-treatment changes. The SS ratios were ranged from 0.66 to 29.15. The lesions with the SS ratio > 9.28 were all benign at follow up of at least two months, whereas those with SS ratio < 1.05 were all recurrent tumors proven by biopsy or surgery. Overlapping occurred when the SS ratios > 1.05 but < 9.28 in which the recurrence was 42.31%. The chance of having recurrence rather than post-treatment changes was approximately two andfive times in patients with the ratio of 5. 07 and 1.55, with the specificity of 54.55% and 90.91%, respectively CONCLUSION: The SS ratio between the artery and the lesion has limitations to differentiate recurrent MSTT from posttreatment changes. It is useful when the ratio is less than 1.05 (malignant) or more than 9.28 (benign). The chance of having recurrence rather than post-treatment changes was approximately two and five times in patients with the ratio of 5.07 and 1.55, respectively The less value the ratio is, the more possibility to be recurrent tumor.