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Pouch of Douglas Liposarcoma—A Rarity

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Open Journal of Obstetrics and Gynecology 2021年第6期11卷 654-659页

作者： J. S. Rajkumar Jayakrishna Reddy Aluru Rajkumar Anirudh Rajkumar Shreya N. Manickavel Sadir J. Alrawi lifeline Institute of Minimal Access Chennai India ACS Medical College and Hospital Chennai India Burjeel VPS hospitals Dubai United Arab Emirates

Introduction: This case report is one of a fairly common tumour in an extremely uncommon anatomic location. Statistically liposarcoma is the commonest type of soft issue malignancy, but publications of such a tumour arising from the pouch of Douglas (POD) to involve the uterus, are very few and far between. Case details: A 52-year-old woman presented with a mass in the lower abdomen, post-menopausal vaginal bleeding, and lower abdominal discomfort. Investigations revealed a large pelvic tumour that was attached to the posterior wall of a bulky uterus. There was no evidence of dissemination of the tumour to distant sites, and a laparotomy was performed. A massive soft tissue tumour occupied the POD. The tumour was dissected out from the surrounding structures, and the uterus and its appendages were removed in to. The histopathological examination revealed a liposarcoma of the pleomorphic type which was arising from the pouch of Douglas (POD), and was attached to the posterior wall of the uterus. Extensive leiomyomatous changes were seen in the uterus. Immunohistochemistry confirmed the liposarcoma to be of pleomorphic type. Conclusion: This case report is being published for its rarity and to illuminate the specific issues in the treatment of this ubiquitous tumour in an unusual site. The involvement of a Multidisciplinary Team (MDT) helps to choose the optimal combination of cytoreductive surgery, chemotherapy, and radiation for a given case with a POD malignancy.

关键词： Pouch of Douglas Liposarcoma Multidisciplinary Approach Cytoreductive

Sternal metastasis-the forgotten column and its effect on thoracic spine stability

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World Journal of Orthopedics 2017年第6期8卷 455-460页

作者： Robert Pearse Piggott Mark Curtin Sudarshan Munigangaiah Mutaz Jadaan John Patrick McCabe Aiden Devitt Department of Trauma and Orthopaedic Surgery Galway University Hospitalsthe West/North West Hospitals GroupHSE

Sternal metastases are not studied extensively in the literature. There is a paucity of information on their role in metastatic disease. The concept of the fourth column was described by Berg in 1993, and has been proven in case report, clinically and biomechanical studies. The role of the sternum as a support to the thoracic spine is well documented in the trauma patients, but not much is known about its role in cancer patients. This review examines what is known on the role of the fourth column. Following this we have identified two likely scenarios that sternal metastases may impact management:(1) sternal pathological fracture increases the mobility of the semi-rigid thorax with the loss of the biomechanical support of the sternum-rib-thoracic spine complex; and(2) a sternal metastasis increases the risk of fracture, and while being medical treated the thoracic spine should be monitored for acute kyphosis and neurological injury secondarily to the insufficiency of the fourth column.

关键词： Fourth column Sternal fracture Sternal metastasis Sternal-rib-thoracic spine complex Spine stability

Airway foreign bodies: A critical review for a common pediatric emergency

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World Journal of Emergency Medicine 2016年第1期7卷 5-12页

作者： Alaaddin M Salih Musab Alfaki Dafalla M Alam-Elhuda Faculty of Medicine International University of Africa College of Medicine and Veterinary Medicine University of Edinburgh Ribat University and Central Police hospitals National Ribat University Faculty of Medicine University of Khartoum

BACKGROUND:Airway foreign bodies(AFBs)is an interdisciplinary area between emergency medicine,pediatrics and *** is a life-threatening condition that is not infrequently seen;however,it is poorly covered in medical *** aspiration of an element into airways is a widespread clinical scenario among children under 3 years,predominantly ***,it is the leading cause of infantile deaths and the fourth one among preschool *** RESOURCES:A systemic search was conducted in July 2015 using Pub Med/Pub Med Central Database of The National Center for Biotechnology Information(NCBI)(http://***/).A total of 1 767 articles were identified and most of them were meta-analyses,systematic reviews,and case *** thoroughly discussing assessment and management of AFBs were ***:AFBs episodes may be either witnessed or *** of a witness for the inhalation is *** later usually present with persistent active cough.A classical triad of paroxysmal cough,wheezing,and dyspnoea/decreased air entry was reported,though many presentations have inconsistent ***,diagnosis requires high index of clinical *** fibro-optic bronchoscopy is the gold standard of diagnosis,whereas inhaled objects are best retrieved by rigid ***:Close supervision of pediatrics is the hallmark of *** should ensure a safe surrounding milieu,including the toys their offspring play *** complications result from direct obstruction or injury by the inhaled ***,prolonged lodging traps air and induces inflammatory response causing atelectesis and pneumonia,respectively.

关键词： Airway foreign bodies Aspiration/inhalation Airway obstruction Car6 coronary syndrome Breathing difficulties

A Rare Case of Nasal Glial Heterotopia Presenting as Sphenochoanal Polyp

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第2期4卷 77-80页

作者： Pavol Surda Jonathan Hobson Ear Nose and Throat Department Warrington and Halton Hospitals Warrington UK

Objective: This paper reports a rare case of nasal glial heterotopia presenting as sphenochoanal polyp. So far, literature has revealed only few cases. Case Report: A 55-year-old woman presented with a 2-month history of left sided nasal obstruction. rigid endoscopy showed greyish left nasal polyp and anterior discharge. Subsequently, CT scan of the sinuses revealed sphenochoanal polyp filling the left nasal cavity, without signs of expansion, or destruction and no obvious connection with intracranial tissue. Mass was removed endoscopically and histology confirmed glial nature of the mass. Conclusion: Any mass arising from sphenoid sinus should be carefully evaluated on CT scan for existence of fibrous stalk, or connection with brain tissue and needs to be considered in the differential diagnosis of the sphenochoanal mass. Complete surgical excision is the treatment of choice, which is curative.

关键词： Heterotopic Glial Heterotopia Sphenoid Sinus Nasal Cavity Sphenochoanal Polyp

Teriparatide anabolic therapy as potential treatment of type Ⅱ dens non-union fractures

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World Journal of Orthopedics 2017年第1期8卷 82-86页

作者： Enrico Pola Virginia Pambianco Debora Colangelo Virginia M Formica Giovanni Autore Luigi A Nasto Spinal Unit Department of Orthopaedics and Traumatology"A.Gemelli" University HospitalCatholic University of Rome Centre for Spine Studies and Surgery Queen’sMedical CentreNottingham University Hospitals NHS Trust

Odontoid fractures account for 5% to 15% of all cervical spine injuries and 1% to 2% of all spine fractures. Type Ⅱ fractures are the most common fracture pattern in elderly patients. Treatment(rigid and non-rigid immobilization, anterior screw fixation of the odontoid and posterior C1-C2 fusion) remains controversial and represents a unique challenge for the treating surgeon. The aims of treatment in the elderly is to quickly restore pre-injury function while decreasing morbidity and mortality associated with inactivity, immobilization with rigid collar and prolonged hospitalization. Conservative treatment of type Ⅱ odontoid fractures is associated with relatively high rates of non-union and in a few cases delayed instability. Options for treatment of symptomatic non-unions include surgical fixation or prolonged rigid immobilization. In this report we present the case of a 73-year-old woman with post-traumatic odontoid nonunion successfully treated with Teriparatide systemic anabolic therapy. Complete fusion and resolution of the symptoms was achieved 12 wk after the onset of the treatment. Several animal and clinical studies have confirmed the potential role of Teriparatide in enhancing fracture healing. Our case suggests that Teriparatide may have a role in improving fusion rates of C2 fractures in elderly patients.

关键词： Type Ⅱ odontoid fractures Non-union Anabolic therapy Teriparatide Fracture healing