External fixation and pseudoaneurysm: report of a case related to tibial lengthening.

External fixators provide a mechanically stable environment to allow fracture stabilization or limb lengthening. Most complications are related to pin or wire insertion. This article presents the case of a 33-year-old man who sustained an open fracture of his left tibia with consequent infection and bone loss.

Atypical teratoid/rhabdoid tumor of the central nervous system in an 18-year-old patient.

Objective: Atypical teratoid/rhabdoid tumors are aggressive neoplasms of the central nervous system occurring mainly in the early childhood and rarely in adults. We described a case of this tumor in an 18-year-old male patient without previous medical history.

Material And Methods: The neoplasm was localized in the right frontotemporal area of the brain and was totally excised.

Metabolic syndrome and sleep apnea.

Metabolic syndrome is a disorder characterized by abdominal obesity, hypertension, increased triglycerides, decreased HDL cholesterol and increased blood glucose. Accumulating evidence strongly indicates that insulin resistance and an increased amount of abdominal fat are the pathogenic factors for the characteristics of metabolic syndrome. The metabolic syndrome is characterized by an increased risk for the development of cardiovascular disease and type 2 diabetes mellitus.

Simultaneous occurrence of cerebellar medulloblastoma and pituitary adenoma: A case report.

Purpose: We present the unusual occurrence of two distinct neoplasms in a 42-year-old woman with an operated pituitary adenoma 18 years ago.

Methods: Clinical history, magnetic resonance imaging studies and histopathological findings were utilized for our diagnostic considerations.

Results: Concomitant presence of a cerebellar medulloblastoma secondary disseminated within the spinal canal and a pituitary macroadenoma, was identified.

Percutaneous radiofrequency ablation of renal cell carcinomas in patients with solitary kidney: 6 years experience.

Objective: In this study we attempt to present our clinical experience in RFA under CT-guidance, in patients with renal cell carcinoma in a solitary kidney.

Material And Method: Between October 2000 and June 2005, 18 patients with solitary kidney and renal cell carcinoma underwent percutaneous CT-guided radiofrequency ablation in our institution. Tumors diameter ranged from 1 to 7 cm and there was no evidence of spread beyond the kidney.

Radiofrequency ablation of osseous metastases for the palliation of pain.

A number of different methods have been proposed for pain relief in cancer patients with bone metastases, each with different indications, contraindications and complications (systemic analgesics, bisphosphonates, antitumor chemotherapy, radiotherapy, systemic radio-isotopes, local surgery and vertebroplasty). The ideal treatment has to be fast, safe, effective and tolerable for the patient. CT-guided radiofrequency (RF) ablation may fulfill these criteria.

Acute coronary syndromes in the elderly.

The elderly constitute an increasingly important sector of patients with acute coronary syndromes (ACS), although they have been under-represented in many therapeutic trials. Elderly patients with ACS usually have more complex co-morbidities and worse outcomes than their younger counterparts, and they are less likely to undergo revascularisation or to receive short- and long-term evidence-based medications. The most common ACS in the elderly is non-ST-segment elevation myocardial infarction (STEMI), which is associated with high mortality.

Metastatic renal clear cell carcinoma in the parotid gland: a study of immunohistochemical profile and cell adhesion molecules (CAMs) expression in two cases.

Metastasis of renal cell carcinoma (RCC) may involve any organ, including the parotid salivary gland. While the definition of salivary gland neoplasms with clear cell transformation can be concluded by the synchronous presence of areas showing typical morphology, sometimes the definition of a metastatic RCC in the parotid is difficult and the application of immunohistochemistry may support the clinical and radiographic observations in the final diagnosis. The aim of this paper was to describe the heterogeneous immunohistochemical features and, furthermore, to characterize the pattern of expression of cell adhesion molecules (CAMs) E-cadherin, beta4-integrin, desmoglein-2, ICAM-1 and CD44s (HCAM) in two cases of metastatic parotid RCC.

The clinical value of mitral A-wave deceleration time in the prediction of a long-term adverse outcome in patients with myocardial infarction.

Introduction: Mitral A-wave deceleration time (Adt) is a promising Doppler parameter for the evaluation of left ventricular (LV) diastolic function. The aim of the present study was to investigate the long-term prognostic value of Adt in relation to the development of heart failure and cardiac death in the setting of the first acute myocardial infarction (MI).

Methods: Conventional Doppler echocardiographic study and Adt measurements were performed in 105 patients (age 60 +/- 10 years, 77 men) 8.

Impact of the metabolic syndrome on atrial size in patients with new-onset atrial fibrillation.

Atrial fibrillation (AF) is the most common arrhythmia, and it is strongly related to atrial enlargement. Metabolic syndrome (MetSyn) is associated with increased cardiovascular morbility and mortality. However, the impact of the MetSyn on cardiac arrhythmias is poorly elucidated.

Repeated balloon inflations do not diminish ST segment elevation even though coronary collateral recruitment is promoted in pigs.

Objective: Attempts to demonstrate preconditioning during repeated angioplasty balloon inflations (BIs) have not been universally successful. The main obstacle is that the first BI is unreliable, due to the variable degrees of occlusion by the deflated balloon. In the present study, we examined whether ST segment elevation decreases and evaluated its relation to collateral recruitment during repeated angioplasty BIs in the pig.

Mechanical failure of a Thompson's hemiarthoplasty stem 28 years post-implantation: an investigation with electron microscopy.

Tauhe authors would like to report a mechanical failure of a Thompson's prosthesis, 28 years post-implantation. A detailed examination of the specimen revealed no defects in the prosthesis and a dominating 'brittle component' fracture of the stem. In this context the detailed fractographic study by scanning electron microscopy (SEM) revealed no detrimental manufactural defects that may have produced microcracks and consequently risked initiating the fracture propagation.

Static indentation test for neocartilage surface hardness in repair of periosteal articular cartilage defects.

The objective of this study was to determine whether hardness of the superficial layer is a useful parameter to characterise cartilage produced by periosteal neochondrogenesis, using rabbit knee lesions as a model. A cartilage defect was created in the right hind knee of anesthetised young adult rabbits, and the defect was then covered with an autologous periosteal graft. At one and eight months postsurgery, rabbits were euthanised, and the articular cartilage lesion sites were evaluated for the histological parameters in a modified O'Driscoll scale, which is the current 'gold standard' for new cartilage properties.

Autoimmune cholangitis presented as fever of unknown origin.

Autoimmune cholangitis is a rare chronic cholestatic liver disease. Fever of unknown origin is defined as a temperature higher than 38.3 degrees C that lasts for more than 3 weeks with no obvious source despite appropriate investigation.

The influence of thrombolytic therapy on C-reactive protein in ST-segment elevation acute myocardial infarction.

Background: Inflammation plays a crucial role in atherosclerotic processes and in acute coronary syndromes (ACS). Strong evidence of this is the elevation of C-reactive protein (CRP) serum levels during an ACS and its short- and long-term prognostic potency. The present study aimed to assess the relation between CRP serum levels and the elevation of cardiac markers in patients with ST elevation acute myocardial infarction (STEMI) as well as the effect of intravenous thrombolysis on a time series of CRP values.

Splenic abscess due to Staphylococcus lentus: a rare entity.

Splenic abscess is an unusual condition, most often seen in immunocompromised patients. Splenic abscesses are due to aerobic and anaerobic bacteria, fungi and parasites, Staphylococcus aureus being the most common aetiological agent. We describe a case of splenic abscess in an alcoholic patient due to Staphylococcus lentus, a rare aetiology included in the microbiology of this disease.

Multifocal skeletal tuberculosis with Rhodotorula minuta co-infection.

Multifocal skeletal tuberculosis comprises lesions occurring at 2 or more locations of the skeleton. We present an atypical case of multifocal skeletal tuberculosis coexisting with Rhodotorula minuta infection in a non-immunocompromized host. The advantages of computed tomography-guided biopsy in establishing the diagnosis and thus influencing treatment are also discussed.

Microalbuminuria is determined by systolic and pulse pressure over a 12-year period and related to peripheral artery disease in normotensive and hypertensive subjects: the Three Areas Study in Greece (TAS-GR).

Microalbuminuria and peripheral artery disease represent 2 different forms of target organ damage due to raised blood pressure. The aim of this study was to investigate the association between blood pressure with microalbuminuria and the appearance of peripheral artery disease after more than a decade, and moreover, to address whether any relationship exists between microalbuminuria and peripheral disease in a Greek Caucasian population. In 1990, 635 normal subjects were examined and their blood pressure was recorded.

Primary talectomy after open total dislocation of the talus: a case report with 13 years follow-up.

Total dislocation of the talus is a rare and severe injury. We report a case of an open total anterolateral dislocation of the left talus with simultaneous contralateral open peritalar dislocation. The former injury was managed with a primary talectomy because of severe contamination and blood supply deprivation.

US of the shoulder: rotator cuff and non-rotator cuff disorders.

Ultrasonography (US) has been shown to be an effective imaging modality in the evaluation of both rotator cuff and non-rotator cuff disorders, usually serving in a complementary role to magnetic resonance imaging of the shoulder. US technique for shoulder examination depends on patient positioning, scanning protocol for every tendon and anatomic part, and dynamic imaging. The primary US signs for rotator cuff supraspinatus tendon tears are tendon nonvisualization for complete tears, focal tendon defect for full-thickness tears, a hypoechoic defect of the articular side of the tendon for an articular-side partial-thickness tear, and flattening of the bursal surface of the tendon for a bursal-side partial-thickness tear.

Freehand two-step CT-guided brain tumor biopsy: a fast and effective interventional procedure in selected patients.

Purpose: To evaluate the efficacy and safety of CT-guided needle biopsy of brain lesions without a stereotactic device, and to determine the best possible indications for this technique.

Methods: From February 2001 to February 2004, 20 patients (12 men, 8 women; age 61-82 years) underwent CT-guided brain lesion biopsy. The procedure started with a brain CT scan for lesion localization and for selection of the inlet for needle insertion.