1/14. sarcoma metastases due to iatrogenic implantation.AIM: To demonstrate the ability of extremity soft tissue sarcomas (STSs) to implant into tissues exposed during surgery. methods: We use two cases to illustrate that wounds created during surgery for STSs, including donor sites for skin grafts, pedicled and free flaps and blood vessels used in reconstruction, should be regarded as potential sites of quasi-local recurrence. CONCLUSIONS: This report reinforces the need for meticulous surgical technique and planning of procedures to avoid contamination of clean areas that might not be included in adjuvant radiotherapy fields. The cases also highlight the pivotal importance of the correct initial management of these uncommon tumours.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/14. Ophthalmic manifestations of neonatal onset multisystem inflammatory disease.PURPOSE: To report the ophthalmic manifestations of neonatal onset multisystem inflammatory disease, a recently recognized, rare systemic disorder characterized by the triad of arthropathy, rash, and abnormal central nervous system development. METHOD: Case report. RESULTS: A 2-year-old female with neonatal onset multisystem inflammatory disease presented with visual acuity of fix and follow with each eye, bilateral optic nerve head pallor and gliosis, as well as marked sheathing of the peripapillary vessels. No vitreous inflammation or macular edema was found. visual acuity was stable from the neonatal period through the 3 months of follow-up after the changes involving the optic nerve heads and peripapillary vessels were observed (a total of 33 months). CONCLUSIONS: This report provides a description of the ocular manifestations of neonatal onset multisystem inflammatory disease and supports earlier suggestions that swelling of the optic nerve heads can occur. In this case, optic nerve head pallor may have been a sequela of such swelling. The pathogenesis of neonatal onset multisystem inflammatory disease is unknown.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
3/14. Synovial histology in three Behcet's disease patients with orthopedic surgery.Specimens of synovial tissues from 5 affected joints of 3 patients with Behcet's disease were available for histopathological examination. All specimens were infiltrated by lymphocytes and neutrophils, and exhibited marked vascularity and infiltration of lymphoid cells among the vessels. Marked plasma cell infiltration and lymphoid follicle formation were found in one synovial tissue sample. There was no evidence of infection or vasculitis. These findings suggest that the histopathological characteristics of synovial tissue in Behcet's disease may have a wide range, some of which may even resemble the synovial tissue of rheumatoid arthritis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/14. bone marrow scan evaluation of arthropathy in sickle cell disorders.Twelve patients with sickle cell hemoglobinopathies and arthropathy were studied, using technetium tc 99m sulfur colloid bone marrow scans. Eight of 12 had decreased marrow radionuclide activity adjacent to painful joints, suggestion obliteration of vessels supplying bone marrow. Four patients without marrow defects on scanning had causes other than infarction for their joint symptoms, viz, small fractures, postinfectious synovitis, degenerative arthritis, and osteochondromas. Roentgenograms never showed bony abnormalities in five patients with marrow infarctions, and, in three others, showed defects several months later than did the marrow scans. bone marrow scans offer a sensitive and early diagnostic aid in sickle cell hemoglobinopathies with arthropathy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/14. Synovial hemangioma. Description of a case.Intra-articular angioma, or vascular hamartoma, is a tumor-like lesion essentially made up of anomalous blood vessels localized in the joint capsule, in the synovial membrane, or in both structures. There are two anatomical varieties: one circumscribed localized and one extended. There seems to be predilection for the female sex, and age of onset ranges from birth to 20-30 years of age; it occurs more frequently in the knee, less in the elbow, in the wrist and in the ankle. Symptoms, which often begin after local trauma, include joint swelling and pain, both characterized by discontinuity and long duration. Sometimes there is an increase in swelling, repeated episodes of hemarthrosis (or hydrarthrosis), forced position and functional limitation of the joint, increase in skin temperature. Final diagnosis can only be obtained with histological examination, although MRI may be useful and arteriography clearly reveals it, if the harmatoma is extended enough and communicating with the circulation. Histological examination carried out on fragments of tissue taken in loco reveals a labyrinthine agglomerate of fissures and lengthening cavities, with walls that are generally thick and of a venous-like anomalous type. The course of the disease is slow, with periods of remission of local symptoms of varying duration. Treatment is surgical and it consists in complete removal when possible of the angiomas. The results, particularly in the localized form, are satisfactory; recurrence is infrequent and it is generally due to incomplete excision of the neoformation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/14. Utility of the inferior gluteal vessels in free flap coverage of sacral wounds.An improved technique for gaining access to the inferior gluteal vessels is presented. This method allows rapid isolation of these vessels, preservation of greater pedicle length, and improved access for the performance of microsurgery. The innervation and function of the gluteus maximus is also preserved. We believe the use of this technique makes the inferior gluteal vessels the receptor vessels of choice for microsurgical procedures in the sacral area. An illustrative patient is presented in whom these vessels were used for a combined serratus anterior-latissimus dorsi free muscle flap for sacral wound coverage.- - - - - - - - - - ranking = 9keywords = vessel (Clic here for more details about this article) |
7/14. Pseudoaneurysm of the inferior medial geniculate artery following primary total knee arthroplasty: delayed presentation with recurrent haemorrhagic episodes.Arterial complications in primary total knee arthroplasty operation are rare. An 83 year old lady is described who presented with three recurrent haemorrhagic episodes eroding through the medial skin 4 weeks following primary total knee arthroplasty. A pseudoaneurysm of the geniculate artery should be suspected with recurrent or persistent haemarthrosis/haemorrhagic episodes. Early exploration, evacuation of the aneurysmal cavity and ligation of the feeding vessel should be undertaken if the false aneurysm is large in diameter.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/14. Recurrent cutaneous vasculitis in cystic fibrosis.We treated a patient with cystic fibrosis who experienced recurrent episodes of palpable purpura and arthralgias associated with exacerbations of her pulmonary disease. Skin biopsy demonstrated the classic findings of leukocytoclastic vasculitis, and C3 deposits were detected in the dermal blood vessels. Chronic bacterial infection and antibiotics are possible sources of antigen involved in immune complex formation in patients with chronic lung diseases.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/14. Production of monoclonal antibody against amyloid fibril protein and its immunohistochemical application.An autopsy case of multiple myeloma (IgA-lambda) with extensive amyloid arthropathy of the systemic joints was described. Heavy deposits of amyloid (amyloidoma) were observed in the articular cavities of the joints. Furthermore, numerous amyloid deposits were found in the walls of small blood vessels in the general organs. Incubation of the paraffin sections of amyloid with potassium permanganate produced little loss of congo red affinity and apple-green birefringence under polarized light. A crude preparation of amyloid protein was isolated from a frozen intra-articular mass, which had been obtained at necropsy, and injected into the footpads of BALB/c mice with complete freund's adjuvant. The immune spleen cells were fused with myeloma cells (P3 X 63-Ag8.653) under the presence of polyethylene glycol. Hybridoma cell lines, producing supernatants which reacted not only with amyloid substances but also with normal human tissues, were omitted from the subjects of recloning, and one hybridoma cell line (Am-1) producing a specific monoclonal antibody (MAb) against the immunized amyloid substance was finally obtained. Using the indirect immunoperoxidase method, the specificity of MAb Am-1 was confirmed in the cryostat sections as well as in the formalin-fixed paraffin sections of various organs of the case from which the crude amyloid protein was obtained and used for immunization. Amyloid deposits in 25 cases with amyloidosis or amyloid deposits were examined with MAb Am-1, and 2 cases showed positive reactivity with Am-1. These 2 cases presented primary amyloidosis and focal amyloid deposits in the oral cavity, respectively; congo red staining of amyloid in these cases showed resistance to treatment with potassium permanganate, as observed in the amyloid of the original case used for immunization. trypsin treatment of the sections resulted in a loss of positive reactivity with MAb Am-1 in all these cases. This result indicates that Am-1 recognizes a substance composed of protein molecules. Furthermore, the immunohistochemical distribution of Am-1 positive reaction was consistent with the histological distribution of substance which could be stained by congo red and showed apple-green birefringence under polarized light. These results have suggested that Am-1 reacts with a portion of amyloid protein which is resistant to treatment with potassium permanganate followed by congo red staining.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/14. tibial nerve entrapment by a Baker cyst: case report.We report a rare case of degenerative joint disease of both knees, complicated by a Baker cyst. Our emphasis is on the role of electromyography and electrodiagnosis in the localization of this nerve entrapment syndrome. The patient presented with pain and swelling; venography revealed deep venous thrombosis of the right calf, including the popliteal and proximal superficial femoral vessels. The patient responded well to bed rest, analgesics, intravenous heparin and subsequent Coumadin anticoagulation, and was discharged two weeks later. Five weeks after onset of these acute problems, nerve conduction studies were done, leading to a diagnosis of Baker cyst with nerve entrapment. He responded well to knee joint aspiration and intraarticular prednisolone injection. Some evidence of improvement in the flexor hallicus longus muscle was detected at three-month follow-up.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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