No abstract available.
Schizophrenia*

No abstract available.
Dermatitis*

We experienced a case of submucosal gastric actinomycosis, presenting as bleeding. The 65-year-old woman had a symptom of epigastric pain, without any other intra-abdominal disease entity. A gastrofiberscopic study demonstrated a submucosal mass lesion with bleeding at the fundus. Because of the bleeding, laparotomy was undertaken, and a abscess containing a large mass was found at the gastric fundus, and total gastrectomy undertaken. Histological examination revealed a giant acute ulcer with a submucosal abscess due to actinomycosis. Because of its rarity, submucosal gastric actinomycosis is an entity overlooked by most surgeons. We report upon this case of submucosal gastric actinomycosis and include a review of the literature.
Female ; Humans

PURPOSE: Tension-free hernioplasty has become the most popular procedure for the repair of groin hernias in the United States and United Kingdom. The purpose of this study is to describe a 7-year personal experience with Lichtenstein's tension-free groin hernia repair under local anesthesia. METHODS: We retrospectively studied the clinical outcome of 321 cases of Lichtenstein repairs, performed consecutively by an experienced surgeon between Jan. 1994 and Dec. 2000. RESULTS: Of the 321 cases, 242 (75.4%) were indirect, 34 (10.6%) were direct, 8 (2.5%) were femoral, 7 (2.2%) were pantaloon, and 30 (9.3%) were recurred hernias. The mean age was 55 years; 91% were male. The mean number of injections of analgesics required in the postoperative period was 3.2. The mean hospital stay following repair was 2.7 days. Complications occurred in 23 cases (7.1%). Most of these were minor, consisting of five cases of bruising or hematomas (1.6%), four superficial infections (1.3%), three seromas (0.9%), two hydroceles (0.6%), six patients with persisting groin pain for more than a month (1.8%), one foreign body granuloma, one urinary retention, and one testicular atrophy. There were no recurrences or operative deaths. CONCLUSION: Lichtenstein's tension-free hernioplasty is an easy and simple technique with less pain, minor complications and only rare instances of recurrence. This procedure can be performed on a same-day basis under local anesthesia. Lichtenstein repair may be the most promising technique for the repair of groin hernias.
Analgesics ; Anesthesia, Local ; Atrophy ; Granuloma, Foreign-Body ; Great Britain ; Groin* ; Hematoma ; Hernia* ; Herniorrhaphy ; Humans ; Length of Stay ; Male ; Postoperative Period ; Recurrence ; Retrospective Studies ; Seroma ; United States ; Urinary Retention

BACKGROUND: Accessory axillary breast tissue is present in approximately 2% to 6% of women, but receives little attention in the surgical literature. Furthermore, a carcinoma, as well as other pathologic changes, can arise within accessory axillary breast tissue. METHODS: Between January 1990 and December 1997 at our clinic, 83 patients underwent surgical removal of accessory axillary breast tissue. All the patients were female, and the ages ranged from 14 to 57 years, with a median of 33.8. The clinical characteristics, indications, and techniques of surgical removal, pathologic findings, and postoperative results were analyzed. RESULTS: The major clinical manifestations were axillary mass (95.2%), pain and/or tenderness (41%), and cyclic change of size (21.7%). In most patients, these symptoms appeared first during puberty (25.3%) and pregnancy (43.4%). On examination, the mass was in the right axilla in 35 patients (42.2%), the left axilla in 19 patients (22.9%) and both axillae in 29 patients (34.9%), and 3 patients had rudimentary accessory nipples. Surgical removal was performed for cosmetic problems (61.5%), clinical symptoms (21.7%), and suspicion of pathologic lesions (9.6%). The excised breast tissue varied in size from 2.5 cm to 14 cm with a median of 6.2 cm. The pathological findings demonstrated ductal dilatation in 21 patients (25.3%), chronic inflammation in 4 patients (4.8%), fibrocystic changes in 3 patients (3.6%) and lactating adenosis in 2 patients (2.4%). Postoperative complications developed in 8 patients (8.3%), and seroma was the most common. In our study, none of the patients experienced recurrence of disease, and 96.4% of the patients enjoyed cosmetically satisfying outcomes. CONCLUSIONS: In conclusion, from our experience, the treatment of choice for accessory axillary breast tissue is surgical removal, which eliminates the clinical symptoms and the aesthetical deformity and provides tissue to rule out any pathologic changes including malignancy. For cosmetically satisfying outcomes, a scar hidden from sight and balanced shapes of both axillae should be kept in mind during the operation.
Adolescent ; Axilla ; Breast* ; Cicatrix ; Congenital Abnormalities ; Dilatation ; Female ; Humans ; Inflammation ; Nipples ; Postoperative Complications ; Pregnancy ; Puberty ; Recurrence ; Seroma