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“Dermatofibrosarcoma protuberans (DFSP) is a superficial sarcoma of intermediate malignancy usually composed of monotonous short spindle cells with storiform architecture. The tumor cells are diffusely reactive for CD34 and characterized by a translocation

involving chromosomes 17 and 22 or a supernumerary ring chromosome that results in the fusion of exon 2 of platelet-derived growth factor beta (PDGF beta;22q13) to various exons of collagen type 1 alpha 1 (COL1A1; 17q22). In some tumors, fibrosarcomatous transformation can occur and is characterized by a monotonous spindle cell proliferation arranged in fascicles or a herringbone-type pattern. We report 4 DFSPs with unusual and pleomorphic sarcomatous transformation. They occurred on the back, scalp, shoulder, and forehead Baf-A1 mouse of women (ages 31,48, 48, and 27 year). In addition Selleckchem HIF inhibitor to areas of conventional DFSP that strongly expressed CD34, 2 cases showed pleomorphic areas mimicking undifferentiated pleomorphic sarcoma/malignant fibrous histiocytoma: 1 case had a patternless area and 1 case had combined round/spindled cells with myxoid areas. Reverse transcription-polymerase

chain reaction was performed in 1 case, confirming the presence of a COL1A1-PDGF beta fusion transcript. The remaining three cases were found to be positive for a PDGF beta gene rearrangement by fluorescence in situ hybridization. This series illustrates that sarcomatous transformation in DFSP may occasionally display areas, which can mimic undifferentiated pleomorphic or unclassified sarcoma. Ancillary diagnostic testing may be helpful to confirm the diagnosis, especially in small biopsies.”
“Obesity seems to be the modern concern to society. An increasing

number of obese patients present annually Selleck SC79 to surgical wards to undergo surgical procedures. As morbid obesity affects most of the vital organs, the anesthesiologist must be prepared to deal with several challenges. These include the preoperative evaluation of the consequences of obesity, particularly on cardiac, respiratory, and metabolic systems; airway management; different pharmacokinetic and pharmacodynamic drug regimen; and perioperative management (i.e., hemodynamic, respiratory, and hyperglycemic). This paper reviews and assesses the most important anesthetic issues in managing obese patients.”
“We report the successful management of a female patient who developed postoperative thrombotic thrombocytopenic purpura (TTP) after an uneventful laparoscopic oophorocystectomy. The patient underwent uneventful laparoscopic surgery for ovarian cystoma. One hour after completion of surgery, the patient suddenly went into shock, with her blood pressure dropping to 60/40 mmHg. Hemorrhage into the abdominal cavity with an estimated blood loss of 2,000 ml was confirmed by exploratory laparotomy.