Giant adenocarcinoma of unknown origin penetrating from the pelvic cavity to subcutaneous tissue: A case report and review of the literature.

In this study, we present a case of a 43-year-old female patient who was admitted to our hospital due to a giant mass on the left buttock. Imaging tests revealed that the mass was a solid-cystic tumor with a large size of 143×430×180 mm, penetrating from the pelvic cavity to the subcutaneous tissue. Pathology tests indicated a metastatic mucinous adenocarcinoma which was most likely of gastrointestinal origin. However, there was no evidence to confirm the existence of malignant changes in the gastrointestinal tract.

[Retrospective study on staged treatment of long bone shaft fractures with severe thoracic trauma].

OBJECTIVE: To evaluate the feasibility and efficacy of staged treatment of patients with long bone shaft fractures and severe thoracic trauma. METHODS: A retrospective study was performed on 41 patients with long bone shaft fractures and severe thoracic trauma who underwent staged treatment under the guidance of damage control orthopedics from January 2005 to October 2009 in our department. Among the patients,29 patients were male and 12 patients were female,with an average age of (37.2 +/- 6.1 ) years (ranged, 17 to 65 years). On admission, the value of injury severity score (ISS) for these patients was above 16 and the average value was 27.4. The therapy process included three stages: first stage,controlling thoracic symptoms and provisionally fixing fracture; second stage, resuscitating and optimizing physiological condition in intensive care unit;third stage, operating for fractures when pathogenic condition was equable. RESULTS: There was no dead case. Pathogenic condition of thorax in all patients regained equable in 5 d to 23 d and long bone shaft fractures were fixed in 10 d to 25 d after injury. There was no seriously operative or postoperative complication. All the patients were followed up, the duration ranged from 6 to 36 months, with an average of 19.4 months. Their respiratory functions were good. The long bone shaft fractures were healed in 10 to 16 weeks among 38 patients. The bone nonunion happened in 1 patient with closed fracture and 2 patients with opened fracture. CONCLUSION: Damage control orthopedics is a safe strategy for treatment of long bone shaft fractures with severe thoracic trauma. It is suggested that the surgeons should take a staged approach to perform damage control and definitive surgery.

[Changes of neuropeptide Y mRNA expression in the cerebral tissues of rat models of subarachnoid hemorrhage].

OBJECTIVE: To investigate the changes in the expression of neuropeptide Y mRNA in the cerebral tissues of rat models of subarachnoid hemorrhage (SAH), to shed light on the prevention and treatment of cerebral vasospasm induced by SAH. METHODS: SAH rat models, saline and sham-operation control groups were respectively established, in which the relative abundance of neuropeptide Y mRNA in the corpus striatum, cerebral cortex, hypothalamus were subsequently measured and compared by reverse transcriptase PCR at 15 min, 30 min and 1, 4, 8, 12, 24, 48 h after corresponding treatment. RESULTS: The abundance of neuropeptide Y mRNA significantly elevated in the cerebral tissues after SAH, and gradually declined with the passage of time, but were still significantly higher than that of saline and sham-operation controls at any of the same time points. CONCLUSIONS: Neuropeptide Y mRNA level in the cerebral tissues significantly elevates after SAH, which may play an important role in inducing cerebral vasospasm.