Highlights Complete laceration of the radial nerve following supracondylar humerus fracture is a rare finding. Radial nerve injury with wrist-drop is seen two weeks after the injury. The sensory disturbance is shown as anaesthesia in the radial nerve distribution. Neurorrhapy was done in conjunction with the open reduction internal fixation of the fracture.
Background To evaluate the dynamic contrast-enhanced MRI (DCE-MRI) parameters for monitoring the neoadjuvant chemotherapy (NAC) response in osteosarcoma and correlate the parameters of histopathology specimens.Methods Patients with pathologically confirmed as osteosarcoma had three cycles of NAC administered. Dynamic MRI were performed on all patients before and after chemotherapy. Semi-quantitative and quantitative parameters were compared between the good response group (TNR ≥ 90 percent) and poor response group (TNR < 90 percent) using the histology response as the reference standard (tumor necrosis rate). The Mann-Whitney U test was used to assess the differences in DCE-MRI parameters before and after NAC. Results 15 patients were enrolled in this study of whom 3 patients lack of preoperative imaging examination, 2 patients inoperable to asess tumor necrosis rate and 1 had an allergy to a contrast agent. DCE-MRI of n = 9 patients were subsequently used for this study. Prior to chemotherapy, there were no statistically significant differences between the good response group and poor response group in TTP, AUC, MAX Slope, Ktrans, Kep, and Ve (P < 0.05). Following the completion of chemotherapy, the TTP, AUC, MAX Slope, Kep and Ktrans were significantly difference between the good response group and poor response group (P < 0.05). The Ve did not show significant difference between the two groups after the chemotherapy (P = 0,121).Conclusion DCE-MRI has effectively monitor the response to NAC during osteosarcoma treatment cycle.
Sebaceous carcinoma is an aggressive tumor derived from adnexal epithelium of sebaceous gland and accounts for 1% of all cutaneous malignancy. Most commonly found at head and neck region. with sebaceous carcinoma in extrimity few than 100 cases have been formally documented. Since this lesion are uncommon, this lession tend to be misdiagnosed. Sebaceous carcinoma is a clinically innocuous appearing lesion with no pathognomonic features. Diagnosis is seldom made before operation and frequently misdiagnosed after operation We present our experienced with sebaceous carcinoma. female 45 years old, with history mass at her left hand grew rapidly during the past 4 months. At the beginning, there was a small wart over the little finger of her left hand that was not changing for the past 30 years. The patient then started scratching the wart until it fell off (1 year ago). The wound initially healed but then the same lesion grew back and became even larger. The patient repeated this habit and the lesion grew into its current size. The lesion itself started to bleed easily and became infected. During the past 4 months, patient also experienced the same lesion growing at her left index finger. Patient also complaint of pain which was localized to the lesion, non-radiating, and was felt increased when the patient scratched at the lesion. We performed resection of tumor and amputation at 4th and 5th fingers and also disarticulation at MCP joint 2nd finger and take a sample as histhopatological examination.
Background: COVID-19 can provide symptoms outside the respiratory tract and musculoskeletal symptoms. Some viruses can indeed cause arthritis, and the genetic material of these viruses can be found in a joint fluid using PCR assays. With this study, we will conduct an examination using PCR on the joint fluid of COVID-19 patients who have musculoskeletal symptoms, especially arthralgia, during the infection. Methods: This cross-sectional study with a descriptive explanation of synovial fluid in COVID-19 patients was performed from April 1st to July 30th, 2021, with patient data collection conducted centrally at Wahidin Sudirohusodo Hospital Makassar Synovial fluid was taken from the knee using the sterile procedure in a patient that met the inclusion criteria, such as hospitalized patients who had positive PCR swab results in the nasopharynx for less than 2 weeks and had arthralgia symptoms on April – July 2021. Other musculoskeletal symptoms (e.g., myalgia and fatigue) were noted. About 2 ml sample of synovial fluid was tested using a PCR kit (M BioCov) in the laboratory. The sample shows a positive result when there is an amplification of RDNP with a CT value below 40. Results: 189 patients with 21 participated, 14 subjects were male, and 7 subjects were female. Age range 18 - 72 years with arthralgia, myalgia, and fatigue symptoms. Only 2 patients had arthralgia, 13 patients had myalgia and arthralgia, 1 patient had fatigue and arthralgia, and 5 patients had all of the symptoms (arthralgia, myalgia, and fatigue). Only 1 patient had direct contact with the COVID-19 patient. PCR test for synovial fluid in all patients showed negative for COVID-19. Conclusion: COVID-19 infection can be manifest in the musculoskeletal system. Detection of COVID-19 virus using a specimen from knee synovial fluid in a patient with musculoskeletal symptoms (arthralgia, myalgia, fatigue) was negative.
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