“
“Soft tissue perineurioma is a very rare tumor composed of entirely of neoplastic perineurial Geneticin Microbiology inhibitor cells. A 54-year-old woman presented with a palpable mass in the right lower leg. The mass was excised. Grossly, the tumor measured 2.0 x 2.0 x 1.5 cm. The cut surface was well circumscribed, pale pinkish gray, and rubbery soft. Histological

examination showed that the tumor was composed of spindle cells within collagenous and myxoid stroma. The tumor cells had elongated, tapering nuclei with long and thin cytoplasmic processes, and were arranged in fascicular, whorled, and storiform pattern. The tumor cells were positive for epithelial membrane antigen and collagen type IV and negative for S-100 protein. Ultrastructurally, tumor cells showed long and thin cytoplasmic processes, pinocytic vesicles, and incomplete external lamina. The diagnosis of soft tissue perineurioma was confirmed by immunohistochemical stain and ultrastructural study.”
“Background: Distal radial fractures affect an estimated 80,000 elderly Americans each year. Although the use of internal fixation

for the treatment of distal radial fractures is becoming increasingly common, there have been no population-based studies to explore the dissemination of this technique. The aims of our study were to determine the current use of internal fixation for the treatment of distal radial fractures in the Medicare population and to examine regional variations and other factors that influence use of this treatment:We hypothesized that internal fixation of distal radial fractures would be used less commonly in male and black populations compared Blebbistatin GS-1101 inhibitor with other populations because the prevalence of osteoporosis is lower in these populations, and that use of internal fixation would be correlated with the percentage of the patients who were treated by a hand surgeon in a particular region.

Methods:

We performed an analysis of complete 2007 Medicare data to determine the percentage of distal radial fractures that were treated with internal fixation in each hospital referral region. We then analyzed the association of patient and physician factors with the type of fracture treatment received, both nationally and within each hospital referral region.

Results: We identified 85,924 Medicare beneficiaries with a closed distal radial fracture who met the inclusion criteria, and 17.0% of these patients were treated with internal fixation. Fractures were significantly less likely to be treated with internal fixation in men than in women (odds ratio, 0.84; 95% confidence interval, 0.80 to 0.89) and in black patients than in white patients (odds ratio, 0.74; 95% confidence interval, 0.65 to 0.85). Patients were more likely to be treated with internal fixation rather than with another treatment if they were treated by a hand surgeon than if they were treated by an orthopaedic surgeon who was not a hand surgeon (odds ratio, 2.