No abstract available.
Child* ; Epilepsy* ; Humans

No abstract available.

Although obturator herniae are rare, they are associated with a high mortality, as diagnosis is often delayed and the condition tends to occur in the elderly. The preoperative diagnosis is difficult because of nonspecific symptoms and sign. They often produce a small bowel obstruction. The treatment is always surgical. Several repair techniques have been described: a sac ligation alone, a direct suture repair, and the use of autologous tissue or prosthetic repair. Recently, the placement of permanent mesh prostheses, in a clean contaminated operative field, has been performed due to the minimal wound-related morbidity and patient mortality. Thus, utilization of a permanent mesh in an obturator hernia is a new, simple and effective method for repair. Two cases of a strangulated obturator hernia were experienced in elderly women. The peritoneal cavity was not overly contaminated, with only necrotic foci on the herniated small bowel wall noted. A segmental resection of the small bowel was performed. Consequently, the hernia defect was closed with mesh- plug between the peritoneum and periosteum of the obturator foramen. Here, two cases of obturator herniae treated by use of a mesh-plug are reported, with a brief review of the literature.
Aged ; Diagnosis ; Female ; Hernia ; Hernia, Obturator* ; Humans ; Ligation ; Mortality ; Periosteum ; Peritoneal Cavity ; Peritoneum ; Prostheses and Implants ; Sutures

BACKGROUND: Pneumonia is a frequent complication in patients undergoing mechanical ventilation. Quantitative culture of protected specimen brush(PSB) have shown satisfactory diagnostic accuracy for the diagnosis of ventilator-associated pneumonia. However PSB method is invasive, expensive, and require a bronchoscopic procedure. But endotracheal aspiration(EA) is simple and less expensive. The purpose of our study was to investigate the diagnosic value of EA quantitative cultures. METHOD: We studied 15 cases of ventilator-associated pneumonia(for >72h of mechanical ventilation) patients. Patients were divided into two diagnostic categories. Group I was the patients who were suspicious of clinical pneumonia, Group II was the patients for control. The obtained samples by EA and PSB were homogenized for quantitative culture with a calibrated loop method in all patients. RESULT: Using 103cfu/ml, 105cfu/ml as threshold in quantitative culture of PSB, EA respectively, we found that EA quantitative cultures represented a relatively sentive(70%) and relatively specific (60%) method to diagnose the ventilator-associated pneumonia. CONCLUSION: Although EA quantitative cultures are less specific than PSB for diagnosing ventilator-associated pneumonia. EA quantitative cultures correlated with PSB quantitative culture in patients with clinical pneumonia and may be used to treat these patients when bronchoscopic procedures are not available.
Diagnosis ; Humans ; Pneumonia ; Pneumonia, Ventilator-Associated* ; Respiration, Artificial