The fat-forming variant of solitary fibrous tumor is rare. It occurs predominantly in the deep soft tissues of the retroperitoneum and thigh. We describe a case of fat-forming solitary fibrous tumor arising from the pleura, which was successfully treated using a video-assisted thoracoscopic approach. The patient remained free of recurrence 2 years after surgery and continues to be under long-term follow-up.
According to this scale, the main criterion for liver damage is an increase in alanine aminotransferase (ALT) activity over 50% of baseline. Also, the enzymatic activity of ALT may be increased in newborns with parenteral nutrition. Objectives The purpose of the study: to study the clinical and laboratory, instrumental and pathomorphological features of septic hepatitis in newborns. Methods An analysis of 32 inpatient maps of children (of which 29 -(90.6%) premature in gestation 27 -34 weeks) with septic hepatitis. The only diagnostic criterion was considered to be a combination of the above components with systemic inflammatory response syndrome (SIRS -systemic inflammatory response syndrome). Results Hepatomegaly was detected in 25 (78%) patients. Hemorrhagic syndrome was detected in 22 (68.7%) infants, most often in the form of pulmonary or gastrointestinal bleeding. Changes in hemostasis in patients were accompanied by an increase in activated. Splenomegaly was detected in 3 (9.4%) children as a result of hyperplasia of the reticulogistiocytic tissue of the organ in response to sepsis and hepatitis. Conjugated hyperbilirubinemia was detected in all 32 patients (100% of cases). Decreased prothrombin index was observed in 25 children (78%), and increased levels of alanine aminotransferase and aspartate aminotransferase (ALT, AST) in 23 (72%). Hypoproteinemia was observed in 12 children (37.5%). Ultrasound in septic hepatitis in 28 (87.5%) patients was characterized mainly by changes in the liver parenchyma and its vascular system, sometimes in combination with biliary tract lesions in the form of thickening of the gallbladder walls and heterogeneity of its contents. Conclusions Clinical symptoms of septic hepatitis are accompanied by jaundice, in most children hepatomegaly and hemorrhagic syndrome. The main laboratory criteria for septic hepatitis were: conjugated hyperbilirubinemia (100%), decreased prothrombin index (78%) and increased levels of ALT and AST (72%). The most unfavorable prognosis was observed as a result of penetration of the pathogen into the liver through the umbilical vein. In these cases, morphologically formed necrotic hepatitis with total damage to all parts of the hepatobiliary system. The clinical symptoms of the disease were characterized by severe hepatic insufficiency with impaired basic liver function and very high mortality.
Aplasia cutis congenita (ACC) is a rare group of congenital disorders characterised by focal or widespread absence of skin, predominantly affecting the scalp. A Malay female infant was born at 37 weeks with extensive ACC, affecting 37% of total body surface area, including her scalp and trunk. There is no consensus on the management of ACC given the rarity and variable presentation. A multi-disciplinary team comprising neonatologists, paediatric dermatologists, plastic surgeons and medical laboratory scientists at the skin bank, employed a more aggressive surgical approach with the aim of avoiding potentially catastrophic morbidity, including sagittal sinus haemorrhage and brain herniation. Out of several surgical options, the team used a staged artificial dermal matrix (Integra) and cultured epithelial autograft application, followed by regular wound dressing, and eventually allowed the child to achieve complete epithelialisation of her trunk, and most of scalp before she was discharged from hospital.
The burn center in our hospital is a national and regional (Southeast Asia) center. Of all admissions, 10% are related to blast explosions, and 8% due to chemical burns. In the acute burn management protocol of Singapore General Hospital, early surgical debridement is advocated for all acute partial-thickness burns. The aim of early surgical debridement is to remove all debris and unhealthy tissue, preventing wound infection and thereby expediting wound healing. In chemical burns, there can be stubborn eschars that are resistant to traditional debridement. We would like to present a novel technique using the diathermy scratch pad as a cheap and efficient tool for the dual purpose of surgical debridement and dermabrasion.
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