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At least 451 records · Page 25Linked to original sources
PubMed1999

Sweat gland adenoma with predominant myoepithelial differentiated features: case report and immunohistochemical study.

A 56-year-old man presented with a subcutaneous mass adjacent to the sternoclavicular joint region, which had predominant spindle-shaped myoepithelial cells and a small number of tubular or trabecular epithelial cells that resembled eccrine differentiation under a light microscope. Immunohistochemical studies showed positive staining for muscle-specific actin and vimentin in the myoepithelial cells, but staining was negative for S-100 protein and keratin. The tubular and trabecular epithelial cells stained positively for keratin, EMA and CEA. We believe that this rare tumor had the potential for biphasic differentiation and should be differentiated from other biphasic differentiated or mixed tumors in this site. Immunohistochemical staining was useful for diagnosis and differential diagnosis.

Adenoma↗
PubMed1999

[Endocrine chemotherapy (high-dose toremifene + 5'-DFUR) found markedly effective for 2 cases of metastatic breast cancer].

Two cases of metastatic breast cancer are reported in which endocrine chemotherapy with Toremifene + 5'-DFUR proved markedly effective. Case 1: A 69-year-old female. After CAF therapy as a adjuvant chemotherapy, Tamoxifen and Tegafur had been administered. At the 5th postoperative year, multiple metastases to lung and a rise in the tumor marker were found. Since the patient was not desirous of intensive chemotherapy, administration of Toremifene 120 mg/day and 5'-DFUR 800 mg/day was initiated. The patient showed PR 9 months after and achieved CR 14 months later. Case 2: A 48-year-old female. CAF therapy for a total of 6 cycles was performed as adjuvant chemotherapy. The patient was administered Tamoxifen and followed. On bone scintigrams 3.5 years after surgery, an abnormal accumulation appeared in the left sternoclavicular joint, and an infiltrative tumor mass was formed in the skin of that region. Administration of Toremifene + 5'-DFUR was initiated. After 6 months, the infiltrative mass disappeared. These findings are suggestive of the effectiveness of this combined chemotherapy.

Aged↗
PubMed2000

Diffuse chronic sclerosing osteomyelitis and the synovitis, acne, pustolosis, hyperostosis, osteitis (SAPHO) syndrome in two sisters.

Two sisters with diffuse chronic sclerosing osteomyelitis of the mandible and the humerus and the synovitis, acne, pustolosis, hyperostosis and osteitis syndrome (SAPHO syndrome) are presented. The diagnoses of diffuse chronic sclerosing osteomyelitis at the age of 12 years and 27 years, respectively, were based on typical medical history, clinical symptoms and radiographic, histologic and scintigraphic findings. Because skin lesions and scintigraphic enhancement of the sternoclavicular joints with hyperostosis were present, a SAPHO syndrome was diagnosed in both sisters. Microbiological cultures of biopsy specimens revealed coagulase-negative Staphylococcus aureus at the humerus and Haemophilus parainfluenzae, Streptococcus, Actinomyces and Veilonella species at the mandible. Repeated operative procedures, including decortications, resection and reconstruction, and multiple histologic and microbiologic studies were performed over a period of up to 20 years. Since HLA typing yielded identical gene loci, we suggest that hereditary and autoimmune factors may play a role in the pathogenesis of these cases.

Acquired Hyperostosis Syndrome↗
PubMed2000

The painful shoulder: part II. Acute and chronic disorders.

Fractures of the humerus, scapula and clavicle usually result from a direct blow or a fall onto an outstretched hand. Most can be treated by immobilization. Dislocation of the humerus, strain or sprain of the acromioclavicular and sternoclavicular joints, and rotator cuff injury often can be managed conservatively. Recurrence is a problem with humerus dislocation, and surgical management may be indicated if conservative treatment fails. Rotator cuff tears are often hard to diagnose because of muscle atrophy that impairs the patient's ability to perform diagnostic maneuvers. Chronic shoulder problems usually fall into one of several categories, which include impingement syndrome, frozen shoulder and biceps tendonitis. Other causes of chronic shoulder pain are labral injury, osteoarthritis of the glenohumeral or acromioclavicular joint and, rarely, osteolysis of the distal clavicle.

Acute Disease↗
PubMed2002

[Skeletal changes during the course of pustulosis palmoplantaris--report of two cases].

We report two cases of coincidence palmoplantar pustulosis and joint changes. Two patients fulfilled criteria for arthroosteitis pustulosa: pustular eruptions of the palms and soles and pain of sterno-clavicular joint. They also fulfills criteria for SAPHO syndrome: osteoarticular manifestations of palmoplantar pustulosis. Clinical examination and scintigraphy confirmed the diagnoses. Treatment was started with antibiotics and nonsteroid anti-inflammatory drugs. Oral corticosteroids therapy with methotrexate was given to one patient.

Adult↗
PubMed2003

Anterior mediastinal extension of primary chest wall infections: role of spiral CT in detection and management.

UNLABELLED: The purpose of this review was to define the role of spiral CT in the diagnosis and clinical management of patients with mediastinal infections resulting from extension of anterior chest wall infections. The review focuses on determining the frequency of mediastinal extension of chest wall infections as well as to define the patterns spread. SUBJECTS AND METHODS: CT scans of 22 consecutive patients collected over a 2-year period with anterior chest wall infections were evaluated both prospectively and retrospectively. Clinical, pathologic, and CT characteristics of the infections were evaluated. The extension of the infection into the mediastinum as well as the role of CT in diagnosis and management of these patients was examined. RESULTS: Of the 22 patients, 10/22 (45.4%) showed CT evidence of mediastinal infection. Extension of chest wall infection occurred in patients with both soft tissue and sternoclavicular joint processes. The assessment of mediastinal involvement was best seen at the level of the great vessels origin from the aortic arch. CT findings in the mediastinum included fat hyperdensity and stranding, fluid collections (abscess), and mass effect on the great vessels. Sensitivity and specificity of CT for determination of mediastinal infection were both 100%. In 5 of 10 cases with evidence of mediastinal extension, the clinical situation required surgical drainage. In the other five cases the patients were managed with antibiotic therapy alone. CONCLUSIONS: Mediastinal involvement of chest wall infections is a common occurrence. Conservative and/or surgical management must be tailored to the patient. Factors to consider in management decisions include the clinical status, CT findings, and patient compliance. Rapid CT evaluation may permit timely surgical intervention, limiting complications in some patients.

Adult↗
PubMed2003

Permanent cardiac pacing through the right supraclavicular subclavian vein approach.

BACKGROUND: The infraclavicular subclavian route is commonly used for insertion of permanent pacing leads. However, the subclavian vein route may at times be a very difficult way to gain access to the heart. OBJECTIVE: To explore a new route to reliably and safely insert pacing leads. METHODS: The right supraclavicular subclavian vein route was selected to implant permanent leads in patients with critical illness or in situations where access through the infraclavicular approach was difficult. Access was achieved by Yoffa's venipuncture technique. A subcutaneous arc tunnel was made to pull the leads over the clavicle, which first arched close to the sternoclavicular joint and then curved to the inlet of the leads. The pacemaker was implanted in a right infraclavicular surgical pocket. RESULTS: This technique was used in 44 patients. The venipuncture time of 4.4+/-1.2 min was faster with the supraclavicular route than with the infraclavicular route. However, there was slightly more blood loss with the supraclavicular route. Total duration of implantation was similar for both routes (supraclavicular route 72+/-16 min and infraclavicular route 75+/-20 min). Lead dislodgement, lead fracture and skin erosion did not occur. CONCLUSION: Pacing through the right supraclavicular subclavian vein route is a safe and reliable alternative in cases where access through the infraclavicular route is difficult.

Critical Care↗
PubMed2003

[Tietze's syndrome in a 2-year old boy].

A 2-year-old boy was seen with a painful swelling of the left costochondral junction. Laboratory examination revealed no signs of infection. Echography and CT-scan revealed swelling of the 4th and 5th costochondral junction and the pectoral muscle. Tietze's syndrome was suspected and a wait-and-see policy was decided on. During follow-up, the symptoms gradually decreased. Ten weeks after the onset of symptoms there was only a slight, painless swelling with normal ultrasound findings. Tietze's syndrome is defined as a benign, painful, non-suppurative and localised swelling of the costosternal, costochondral or sternoclavicular joints with spontaneous regression of symptoms. It is typically described in adults but appears in children and infants as well. Recognition of this syndrome and knowledge of its favourable outcome can prevent invasive diagnostic procedures.

Child, Preschool↗
PubMed2003

[Leading symptom shoulder pain].

Pain in the shoulder should prompt a systematic clinical examination that adheres closely to the functional anatomy. The basic examination of the shoulder joint comprises active and passive movements and isometric resistance tests with the aid of which external and internal rotation and abduction/adduction can be investigated. The results of these tests provide the physician with a "pattern of findings" which unequivocally identifies the pain-triggering structure. Accordingly, shoulder pain can be classified into four categories as proposed by Cyriax. As treatment, intra-articular injections of corticoids or local anesthetics as determined by findings, where necessary supported by physiotherapeutic measures. Rupture of a tendon, in particular in the case of an active patient, is an indication for surgery.

Acromioclavicular Joint↗
PubMed2003

Bipolar clavicular injury.

While clavicular injuries are fairly common, bipolar clavicular injuries are not. They may involve dislocations at both ends of the clavicle, or a fracture at one end and a dislocation at the other. We present two cases; a patient with a bipolar clavicular dislocation, and another with a fracture in both medial and lateral ends of the clavicle with anterior dislocation of the sternoclavicular joint. Both were treated conservatively, with fairly good range of motion and return to normal activity.

Accidental Falls↗
PubMed2004

Clinical application of axonal repair technique for treatment of peripheral nerve injury.

OBJECTIVE: To evaluate the efficacy of axonal repair technique for treatment of peripheral nerve injury clinically. METHODS: In 1998, the authors applied axonal repair technique to treat peripheral nerve injuries in 12 patients with 13 nerves. It consists of four steps, ie, stumps of the nerve being soaked in a modified Collins fluid, freezed, trimmed, and coapted with glue, making the injured nerve repaired at the axonal level. RESULTS: The patients were followed up for an average of 13 months. Results showed that in 4 cases of first-stage contralateral C7 transfer, regenerating axons reached to the sternoclavicular joint or axilla at 4 to 7 months, offering the timing for performing the second-stage contralateral C7 transfer. In 5 cases of accessory nerve transferred to the suprascapular nerve, the abduction of the shoulder was 40 degree on average. In the other 3 patients with four different nerves repaired, results were also satisfactory. CONCLUSIONS: This technique is promising in the treatment of peripheral nerve injury.

Adult↗
PubMed2005

[Video-assisted thoracoscopic surgery for migration of an orthopedic fixation wire in the mediastinum: report of a case].

Migration of an orthopedic fixation wire into the thoracic cavity is an uncommon complication. We present a 64-year-old male undergoing intra-thoracic migration of a Kirschner wire. The patient had undergone the treatment of sternoclavicular joint dislocation due to clavicular fracture. Four months after the operation, a chest X-ray revealed a metallic foreign body in the mediastinum. A chest computed tomography (CT) showed the object in the anterior mediastinum adjacent to the aortic arch. An emergency video-assisted thoracoscopic surgery was successfully performed to remove a 60-mm-long Kirschner wire migrated from the mediastinum to the thoracic cavity. The operating time was 45 minutes, and the blood loss was less than 50 ml. His postoperative course was uneventful and he was discharged at the 6th day after surgery. Prompt diagnosis and surgical removal are necessary to prevent serious complications.

Bone Wires↗
PubMed2006

[Clinically anatomic study on the relation between the form of pleural cupula and its surrounding commonly-used acupoints].

OBJECTIVE: To explore the relation of the form of pleural cupula of the normal adult with safety of acupuncture at commonly-used acupoints around the pleural cupula. METHODS: The safe depth for the commonly-used acupoints around the pleural cupula and the relation with the form of pleural cupula were investigated in 46 adult corpses with small Kirschner wire location and arrangement dissection. RESULTS: The width of the pleural cupula projection equal to clavicle medial 1/3 accounted for 32. 6% of all the corpses, and the width of the pleural cupula projection more than clavicle medial 1/3 accounted for 59. 8% of all the corpses, the width of the pleural cupula projection less than clavicle medial 1/3 and pleural cupula medial margin located at the sternoclavicular joint medial accounted for 7.6% of all the corpses. The observed points such as Tiantu (CV 22), Qishe (ST 11), Jianjing (GB 21), Dingchuan (EX-B1), Dazhu (BL 11) which were considered be not related to the pleural cupula. When acupuncture is carried out according to criteria of acupoint location and needling direction, and the needle exceeded a limit, the pleural menbrane will be broken and induce destruction. CONCLUSION: Position and form of the pleural cupula have anatomical relation to acupuncture accident for needling the points around the superior pleural cupula, which should be played attention to.

Acupuncture Points↗