Hemangiomas are known to be common benign tumors. However, hemangiomas of female genital organs are very rare. Furthermore, a retroperitoneal hemangioma arising from ovarian vessels has never been reported. Here we report a case of a 29-year-old woman with a retroperitoneal cavernous hemangioma arising from the ovarian vessels of infundibulopelvic ligament, which was treated with laparoscopic resection. The operating time was 30 minutes, and resection was carried out with minimal blood loss. The postoperative period was uneventful, and the patient was discharged on postoperative day 3. Laparoscopic resection of this type of hemangioma is feasible.

(-)-Epigallocatechin-3-gallate (EGCG), a major green tea polyphenol, was tested for in vitro cytotoxicity against human laryngeal epidermoid carcinoma of the larynx Hep2 cells. EGCG-induced apoptotic cell death accompanied by a change in the cell cycle. However, EGCG did not result in caspase activation, nor did a caspase inhibitor block cell death. Furthermore, EGCG caused no change in the intracellular levels of reactive oxygen species (ROS). The levels of p53 were increased in the EGCG-treated cells, with a corresponding decrease in Bcl-2 and Bid protein levels as well as an increase in the Bax level. In addition, EGCG induced the cytoplasmic release of cytochrome c from the mitochondria accompanied by a decreased mitochondrial membrane potential, and subsequently upregulated translocation of apoptosis-inducing factor (AIF) and endonuclease G (EndoG) into the nucleus during the apoptotic process. Taken together, these findings indicate that the p53-mediated mitochondrial pathway and the nuclear translocation of AIF and EndoG play a crucial role in EGCG-induced apoptosis of human laryngeal epidermoid carcinoma Hep2 cells, which proceeds through a caspase-independent pathway.

The popliteal artery is vulnerable to injury during surgeries performed around the knee joint. Pseudoaneurysm of the popliteal artery following a high tibial osteotomy is rare. Few case reports describe the development of this complication after a lateral closing wedge high tibial osteotomy. Our patient underwent an uneventful medial opening wedge high tibial osteotomy and autogenous bone grafting fixed with dual plating for medial osteoarthritis of the knee. The procedure was performed under tourniquet control, which was released only once after the wound closure. Postoperatively, the dressing was soaked, and a large volume of hemorrhagic collection was present in the suction drain. The patient experienced decreased sensation over the sole, which was successfully treated conservatively with medication. Other clinical parameters like motor function and distal pulses were normal. The patient was discharged after 2 weeks. Two days later, the patient presented with pain and numbness over the entire lower limb and a pulsatile swelling in the popliteal fossa. A femoral angiogram revealed a pseudoaneurysm arising from the popliteal artery just below the osteotomy site. Open vascular surgery with resection of the pseudoaneurysm and end-to-end anastomosis using contralateral saphenous vein interposition graft was performed. During the vascular surgery, a pinhead-sized tear was clearly identified on the anterior wall of the popliteal artery, which may have occurred while using the oscillating saw during opening wedge high tibial osteotomy. Careful placement of retractors around the osteotomy site during sawing and flexing the knee to displace the popliteal artery away are recommended to prevent this complication. To our knowledge, this is the first report of a popliteal artery pseudoaneurysm occurring after a medial opening wedge high tibial osteotomy.

OBJECTIVES: The objective of this study was to evaluate the peri-implant's hard and soft tissue response associated with the 1-stage, nonsubmerged, endosseous dental implant. STUDY DESIGN: A multicenter retrospective clinical evaluation was performed on 339 nonsubmerged implants placed in 108 patients at 5 clinical centers between January 2003 and December 2007. RESULTS: After a mean follow-up period of 30 months, the mean crestal bone resorption in 339 implants was 0.43 mm. The survival and success rates were observed to be 99.1% and 95.1%, respectively. The mean calculus, inflammatory, and plaque indices were 0.13, 0.37, and 0.73, respectively, and the mean width of buccal keratinized mucosa was observed to be 2.43 mm. CONCLUSION: The short- to intermediate-term evaluation of the 1-stage, nonsubmerged, endosseous implant yields relatively high survival and success rates.

Retroperitoneal teratoma with malignant transformation is a rare condition in adults. Its most common malignant transformation is into a squamous cell carcinoma, but rarely into a mucinous adenocarcinoma. Postoperative treatment of mucinous adenocarcinoma arising from teratomas has not been established due to its rare incidence. Here we present a case of retroperitoneal mucinous adenocarcinoma arising from a teratoma in the presacral area. Operative and postoperative managements are described with a brief review of the literatures.

The development of endometrial stromal sarcomas (ESSs) in foci of endometriosis is extremely rare, and few cases have been reported in the literature to date, particularly with regard to multiple extrauterine ESS. Here we report a case of endometrial stromal sarcoma with multiple metastasis that arose from an ovarian endometriotic lesion. The literature is also briefly reviewed.

This study compared the quality of life (QOL) between Korean and Korean American older adults. The participants included 306 older adults (155 Korean, 151 Korean American) age 65 and older who met eligibility criteria and agreed to participate in the study. No significant difference was found in QOL between Korean and Korean American older adults. Differences in the subcategories of QOL between the two groups in cluded higher scores for the Korean older adults in physical functioning, social functioning, and body pain. Scores for the subcategories of role limitations due to physical problems and vitality were higher for the Korean American older adults. Multiple regression analysis revealed that the powerful predictors of QOL for both groups were self-esteem and activities of daily living (ADLs)/instrumental ADLs (IADLs). It is recommended that nursing interventions to increase self-esteem and performance of ADLs/IADLs be developed to enhance QOL among older adults.

PURPOSE: The present study was undertaken to evaluate our recent experience with mandibular osteoradionecrosis (ORN) and to identify factors that contribute to its progress. PATIENTS AND METHODS: The medical records of 114 patients who had been treated for ORN during a 16-year period (1989 to 2004) were reviewed. The patients were then divided into 2 groups according to their response to conservative treatment. Group 1 consisted of patients whose ORN resolved with conservative treatment (n = 47). Group 2 consisted of patients whose ORN was unresolved with conservative treatment or who had required radical resection of the involved tissue (n = 67). The information was obtained from the medical records of the patients and analyzed. RESULTS: The patients whose ORN was associated with an early-stage tumor or preirradiation extraction had a favorable response to conservative treatment. However, those who had an advanced primary tumor, had continued smoking and drinking after radiotherapy, had received palliative radiotherapy or a radiation dose of more than 6,000 rads, and who had an orocutaneous fistula, a pathologic fracture, swelling, or trismus had a poor response to conservative treatment. In these latter cases, radical resection of the involved tissue proved useful. CONCLUSIONS: The results of the present study have indicated that several factors (ie, the stage of the primary tumor, signs of ORN) can influence the progress of ORN. Our results suggest that radical resection is a useful method for treating mandibular ORN that does not respond to conservative treatment.

OBJECTIVE: The aim of this study was to compare survival outcomes and toxicities between concurrent radiotherapy with cisplatin plus 5-fluorouracil and that with cisplatin plus paclitaxel in patients with locally advanced cervical carcinoma. METHODS: We retrospectively reviewed data from 93 locally advanced cervical carcinoma patients (stage IB to IVA) who had been treated by concurrent radiotherapy with cisplatin plus 5-fluorouracil (CF, n=45) vs. cisplatin plus paclitaxel (CP, n=48) as primary therapy. Toxicities and survival outcomes were compared. RESULTS: In the CP group, there were higher frequencies of severe (grade 3 or 4) leukopenia (79.2%, as compared to 11.1% in the CF group), severe neutropenia (77.1%, as compared to 8.9% in the CF group) and severe peripheral neuropathy (12.5%, as compared to 2.2% in the CF group). In the CF group, there were higher frequencies of severe nausea (33.3%, as compared to 14.6% in the CP group) and severe hyponatremia (11.1%, as compared to 0% in the CP group). Five-year DFS of the CF and CP groups was 67.4% and 79.1%, respectively (p=NS). Five year OS of the CF and CP groups was 79.6% and 80.9%, respectively (p=NS). CONCLUSION: Concurrent radiotherapy with cisplatin plus paclitaxel showed increased leukopenia, neutropenia and peripheral neuropathy, but less gastrointestinal toxicity (nausea) than that with cisplatin plus 5-fluorouracil. Survival outcome between these two groups was not statistically different in this study. Large prospective randomized controlled studies will be needed to confirm this result.

Calcific tendinitis results from the deposition of calcium hydroxyapatite crystals in periarticular muscular attachments. It is a rare cause of knee pain commonly affecting patients aged 40 to 70 years. Although commonly seen in the shoulder, it should be kept in mind in nontraumatic cases, particularly when the pain is severe and localized to the lateral aspect of the knee. The exact mechanism of hydroxyapatite deposition is unclear, although genetic and metabolic factors have been suspected. A 45-year-old man presented with severe pain in the lateral aspect of his knee with local tenderness over the lateral epicondyle. Radiographs revealed multiple calcific deposits just below the lateral epicondyle of the femur. Magnetic resonance imaging showed multiple areas of low-signal present intra-articularly near the popliteus tendon that was suspected to be calcification. Erythrocyte sedimentation rate and C-reactive protein were slightly raised and other blood investigations including uric acid were within normal limits. Due to failure of conservative treatment, arthroscopy was performed through standard anteromedial and anterolateral portals. Arthroscopy revealed reddish synovial congestion in the lateral gutter. Partial synovectomy was performed with a shaver through a superolateral portal and the calcific deposit was found to lie between the popliteus tendon and the lateral collateral ligament. This was excised and sent for biopsy. Histopathological evaluation revealed the presence of hydroxyapatite crystals within degenerated tendon thereby confirming the diagnosis of calcific tendinitis. Immediate resolution of symptoms following excision allowed the patient to perform activities of daily living immediately postoperatively without pain.