Survival of atlanto-occipital dissociation correlates with atlanto-occipital distraction, injury severity score, and neurologic status.

Background: Case series suggest that atlanto-occipital dissociation (AOD) is a potentially survivable injury. Intuitively, a significant neurologic injury, a high degree of initial distraction, and more severe associated injuries would decrease the likelihood of survival. However, this has never been demonstrated for this injury pattern in a statistically meaningful way.

Defining and detecting missed ligamentous injuries of the occipitocervical complex.

Study Design: Retrospective radiographic and clinical review of patients in a comprehensive trauma database.

Objective: The primary aim of this study was to detect occipitocervical complex (OCC) injuries initially missed at a level 1 trauma center.

Summary Of Background Data: Recent case series demonstrate that OCC injuries are potentially survivable.

SERPINE 1 Links Obesity and Diabetes: A Pilot Study.

In the past decade there has been a dramatic increase in the number of Americans considered obese. Over this same period, the number of individuals diagnosed with diabetes has increased by over 40%. Interestingly, in a great number of cases individuals considered obese develop diabetes later on.

Are you ready?--lessons learned from the Fort Hood shooting in Texas.

On November 5, 2009, a US Army psychiatrist allegedly opened fire with one or more handguns, killing 12 military personnel and one civilian at Fort Hood in Killeen, Texas. The most severely wounded casualties were transported to Scott and White Memorial Hospital, a Level I trauma center and tertiary care teaching hospital in Temple, Texas associated with the Texas A&M University College of Medicine. Ten victims arrived in a 1-h period with another two arriving in the second hour, necessitating an emergency response to a mass casualty event.

Molecular characterization and antibiotic susceptibility of Staphylococcus aureus from a multidisciplinary hospital in Romania.

From 2004 to 2005, 60%-72% of invasive Staphylococcus aureus isolates from Romanian hospitals were resistant to methicillin (methicillin-resistant S. aureus [MRSA]), the highest frequency for any European nation. Few reports, however, have addressed the molecular characteristics of S.

Hemorrhagic complication during placement of tension-free vaginal tape.

A 66-year-old para III with a 20-year history of stress urinary incontinence underwent placement of tension-free vaginal tape. Intraoperative arterial bleeding occurred. An expanding hematoma was palpated postoperatively.

Universal MRSA nasal surveillance: characterization of outcomes at a tertiary care center and implications for infection control.

Background: Recognition of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage by active surveillance cultures has been widely debated. Our institution implemented universal nasal screening by polymerase chain reaction (PCR) for MRSA and isolation of screen positive patients in December 2007. Here we present data about the correlation between screen positivity and subsequent development of infection and the impact of isolation on surgical site infection rates.

Aneurysm of the petrous portion of the internal carotid artery at the foramen lacerum: anatomic, imaging, and otologic findings.

Aneurysms of the petrous portion of the internal carotid artery (ICA) are rare. Their etiology is usually congenital, traumatic, or mycotic. Depending on the size and location of the aneurysm, the direction of its growth, and the specific adjacent structures involved, patients may or may not present with signs and symptoms.

CD99-positive large cell neuroendocrine carcinoma with rearranged EWSR1 gene in an infant: a case of prognostically favorable tumor.

The first case of large cell neuroendocrine carcinoma arising in an infant is presented. The tumor arose at the anal verge of a 1-year-old girl. The diagnosis of this CD99-positive tumor was supported by expression of epithelial (keratins, EMA, and Ep-CAM) and neuroendocrine (chromogranin A, synaptophysin, and neuron-specific enolase) markers and absence of immunoreactivity for Fli-1.

Treatment options for chronic refractory idiopathic thrombocytopenic purpura in adults: focus on romiplostim and eltrombopag.

Idiopathic thrombocytopenic purpura (ITP) is a platelet disorder that affects approximately 1 in 10,000 people. In adults, the rate of spontaneous remission is only 5%, and generally, it is a chronic disease persisting for more than 6 months. Chronic refractory ITP may be defined as the failure of any modality to keep the platelet count above 20 x 10(3)/mm(3) for an appreciable time without unacceptable toxicity.

Single premedication dose of dexamethasone 20 mg IV before docetaxel administration.

Background: The administration of docetaxel requires the use of dexamethasone for the prevention of hypersensitivity reactions (HSRs) and fluid retention reactions (FRRs). The manufacturer recommends dexamethasone for 3 days starting the day before docetaxel. This regimen has the potential for nonadherence so the utility of a single dexamethasone dose would be welcomed.

Pericentric inversion (12)(p12q13-14) as the sole chromosomal abnormality in a leiomyoma of the vulva.

We present a case of a leiomyoma of the vulva with karyotype 46,XX,inv(12)(p12q13-14). It is noteworthy that the breakpoint at 12q13 approximately q14 is flanked by the HMGA2 gene. Although the gene remained intact, the presence of HMGA2 protein in the neoplastic cells indicates that it became activated by the rearrangement.

Enteroaggregative Escherichia coli: An Emerging Enteric Food Borne Pathogen.

Enteroaggregative Escherichia coli (EAEC) are quite heterogeneous category of an emerging enteric pathogen associated with cases of acute or persistent diarrhea worldwide in children and adults, and over the past decade has received increasing attention as a cause of watery diarrhea, which is often persistent. EAEC infection is an important cause of diarrhea in outbreak and non-outbreak settings in developing and developed countries. Recently, EAEC has been implicated in the development of irritable bowel syndrome, but this remains to be confirmed.

Endoscopic ultrasound-guided fine-needle aspiration with aspirate assay to diagnose suspected mediastinal parathyroid adenomas.

Objective: To describe our experience with mediastinal parathyroid adenomas diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and measurement of parathyroid hormone.

Methods: We describe the clinical and pathologic findings and diagnostic techniques used in 2 study patients.

Results: Patient 1 was a 54-year-old man with persistently elevated serum calcium and parathyroid hormone concentrations despite removal of a right inferior parathyroid adenoma.

Nodular mucinosis of the breast: expanding our understanding with an unusual case.

Nodular mucinosis of the breast is an extraordinarily rare lesion that occurs in patients who do not have Carney syndrome. Typically, the affected patients are young women with no medical history and a nodule under 1 nipple. Histopathologic examination has, until now, shown a multinodular myxoid lesion containing scattered capillaries and histiocytes but void of epithelial components.

Postoperative instrumented spine infections: a retrospective review.

Background: Postoperative infection following posterior instrumentation of the spine is not uncommon and is a potentially catastrophic complication. Removal of the instrumentation is ideal for eradicating infection. However, removal is not always possible from a structural standpoint.

Chaperokine function of recombinant Hsp72 produced in insect cells using a baculovirus expression system is retained.

Extracellular heat shock protein 72 (Hsp72; inducible form of the 70-kDa heat shock protein) plays a critical role in innate and adaptive immune responses and has shown promise as an ideal adjuvant for the optimization of antigen-specific anti-tumor vaccines. Recent studies suggest that to correctly elucidate the mechanisms by which Hsp72 exerts its beneficial effects in vitro, great care must be taken to ensure that endotoxin by-products do not invalidate the findings. In this study, we have taken advantage of the baculovirus expression vector system for production of endotoxin-free recombinant Hsp72.

A serious complication following placement of posterior Prolift.

A 32-year-old female with Crohn's disease experienced a rectovaginal fistula and abscess with rectal expulsion of posterior Prolift. She underwent diagnostic laparoscopy, transanal incision and drainage of abscess, transanal excision of mesh, and laparotomy with loop ileostomy. Weeks later, she underwent colectomy, near-total proctectomy, end ileostomy, and fistula repair.

Up-regulation of Bcl-xl by hepatocyte growth factor in human mesothelioma cells involves ETS transcription factors.

Bcl-xl and the hepatocyte growth factor (HGF) receptor c-Met are both highly expressed in mesotheliomas, where they protect cells from apoptosis and can confer resistance to conventional therapeutic agents. In our current study, we investigate a model for the transcriptional control of Bcl-xl that involves ETS transcription factors and the HGF/Met axis. In addition, the effects of activated c-Met on the phosphorylation of the ETS family transcriptional factors were examined.

Perineurioma of the adrenal gland.

The authors report the first case of perineurioma of the adrenal gland. The tumor was composed of elongated wavy spindle cells focally arranged in a fascicular pattern. It was positive for epithelial membrane antigen (EMA) and claudin-1, and was negative for S-100 protein and glial fibrillary acidic protein (GFAP).

An unusual self-limited clonal Mott cell proliferation with lymphoplasmacytic lymphoma-like features in a child with the Wiskott-Aldrich syndrome and Von Recklinghausen's neurofibromatosis.

Patients with the Wiskott-Aldrich syndrome are at high risk for development of lymphomas, which are predominantly extranodal and of the immunoblastic type. We present a case of a self-limited lymphoproliferation with features of lymphoplasmacytic lymphoma arising in a patient with the Wiskott-Aldrich syndrome. The patient also had stigmata of von Recklinghausen's neurofibromatosis.

Effect of estrogen replacement on the histologic response to polypropylene mesh implanted in the rabbit vagina model.

Objective: The aim of this study was to determine the effect of estrogen replacement after ovariectomy on the histologic response to polypropylene mesh implanted in rabbit vagina.

Study Design: Thirty rabbits were assigned to 5 groups: sham laparotomy, ovariectomy, ovariectomy-preoperative estrogen, ovariectomy-postoperative estrogen, or ovariectomy-preoperative and postoperative estrogen. Rabbits underwent sham surgery or ovariectomy and were infused with vehicle or 17beta-estradiol (200 microg/d) for 4 weeks ("preoperative" estrogen).