No abstract available.
Adolescent* ; Humans

No abstract available.
Failure to Thrive*

No abstract available.
Addison Disease*

No abstract available.

No abstract available.
Child* ; Humans ; Lung Diseases, Interstitial*

No abstract available.
Brain Stem Infarctions*

Congenital cystic lymphatic malformations on the extremities are very rare. The patient described in this case study presented with a cutaneous and pedicled macrocystic lymphatic malformation that was eliminated by electrocauterization. A 4-day-old female infant with a congenital cutaneous mass on the dorsal area of her left first metacarpophalangeal joint presented to an outpatient clinic. An electrocautery device was used to cut the pedicle gently with minimal bleeding to avoid mass rupture and to minimize morbidity. A simple wet dressing was applied for 1 week, and the wound subsequently healed completely. Cutaneous macrocystic lymphatic malformations are very rare, especially on the extremities, and no consensus exists on their treatment, which has not been previously described. This report presents this rare case, along with a review of the literature.
Ambulatory Care Facilities ; Bandages ; Consensus ; Electrocoagulation ; Extremities ; Female ; Hemorrhage ; Humans ; Infant ; Lymphatic Abnormalities ; Lymphocele ; Metacarpophalangeal Joint ; Rupture ; Skin Neoplasms ; Upper Extremity ; Wounds and Injuries

PURPOSE: To compare the clinical results of an arthroscopic rotator cuff repair with those of a mini-open repair. MATERIALS AND METHODS: Sixty-three patients with a rotator cuff tear were enrolled in this study. Thirty patients had an arthroscopic repair and 33 patients underwent a mini-open repair. The average age was 50 years (range, 23-74) in the arthroscopic group and 50 years (range, 38-69) in the mini-open group. In the arthroscopic group, 8 patients had small-sized tears (<1 cm), 18 patients had medium tears (1-3 cm), and 4 patients had large tears (3-5 cm). In the mini-open group, 12 patients had small tears, 19 patients had medium tears, and 2 patients had large tears. The average follow-up period in the arthroscopic and mini-open groups was 39 (range, 24-77) and 40 months (range, 24-64), respectively. RESULTS: The level of shoulder pain [1.10 vs. 1.45, p>0.05], the range of motion, muscle strength, patient's satisfaction, the ASES score [91.7 vs. 88.6, p>0.05] and the UCLA score [32.4 vs. 31.2, p>0.05] were compared. The size of the tear did not produce different results. In the arthroscopic group, the tendon tore again in one patient, and one anchor-related complication was noted. In the mini-open group, one patient developed a stiff shoulder. CONCLUSION: An arthroscopic and a mini-open repair of rotator cuff tears produced similar clinical results and the size of the tear had little effect. The clinical results depend on the surgical technique and the patient's condition, rather than the method of repair.
Follow-Up Studies ; Humans ; Muscle Strength ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder ; Shoulder Pain ; Tendons

PURPOSE: The anastomotic leakage rate after rectal resection has been reported to be approximately 2.5-21 percent, but most results were associated with open surgery. The aim of this study was to identify risk factors and their relationship to the experience of the surgeon for anastomotic leakage after laparoscopic rectal resection. METHODS: Between March 2003 and December 2008, 156 patients underwent a laparoscopic rectal resection without a diverting ileostomy. The patients' characteristics, the details of treatment, the intraoperative results, and the postoperative results were recorded prospectively. Univariate and multivariate analyses were applied to identify risk factors for anastomotic leakage. RESULTS: The majority of operations were performed for malignant disease (n = 150; 96.2%), and 96 patients (61.5%) were males. Conversion to open surgery occurred in 1 case (0.6%). The anastomotic leak rate was 10.3% (16/156), and there were no mortalities. In the univariate analysis, tumor location, anastomotic level, intraoperative events, and operation time were associated with increased anastomotic leakage rate. In the multivariate analysis, anastomotic level (odds ratio [OR], 6.855; 95% confidence interval [CI], 1.271 to 36.964) and operation time (OR, 8.115; 95% CI, 1.982 to 33.222) were significantly associated with anastomotic leakage. CONCLUSION: The important risk factors for anastomotic leakage after laparoscopic rectal resection without a diverting ileostomy were low anastomosis and long operation time. An additional procedure, such as diverting stoma, may reduce the anastomotic leakage if it is selectively applied in cases with these risk factors.
Anastomotic Leak ; Conversion to Open Surgery ; Humans ; Ileostomy ; Laparoscopy ; Male ; Multivariate Analysis ; Prospective Studies ; Risk Factors

Several medications are associated with the production of crystals that are insoluble in human urine. Intratubular precipitations of these crystals can lead to acute renal insufficiency. Many patients who require treatment with these medications have additional risk factors, such as volume depletion, underlying renal insufficiency and immunocompromised state that increase the risk of drug induced intrarenal crystal deposition. We experienced a case of crystal-induced acute renal failure due to acyclovir in a 44 year-old male renal allograft recipient. He was diagnosed as Varicella Zoster at 12 days after transplantation, and treated with intravenous (IV) acyclovir (IV infusion of acyclovir 250 mg mixed with normal saline 100 mL within several minutes three times a day, total seven times). Two days after initiation of IV acyclovir, serum BUN was increased up to 160 mg/dL, serum creatinine was increased up to 9.9 mg/dL and urine output was decreased to anuria. With discontinuation of acyclovir, hemodialysis was started as treatment of renal insufficiency. Renal function was restored after discontinuation of acyclovir.
Acute Kidney Injury* ; Acyclovir* ; Adult ; Allografts ; Anuria ; Chickenpox ; Creatinine ; Herpes Zoster ; Humans ; Male ; Renal Dialysis ; Renal Insufficiency ; Risk Factors