Hughes-Stovin syndrome is an extremely rare entity. We present a case of a 42-year-old man, who developed deep vein and inferior vena cava (IVC) thrombosis, repeated internal bleeding and pulmonary artery aneurysms (PAAs). The patient presented with massive hemoptysis and with PAAs of a 2.5 cm maximum diameter. We describe the successful percutaneous transhepatic venous embolization of the PAAs due to occluded common vascular pathways to the pulmonary artery.
Adult ; Aneurysm* ; Hemoptysis ; Hemorrhage ; Humans ; Pulmonary Artery* ; Thrombosis ; Veins ; Vena Cava, Inferior

A multitude of methods for correction of the residual cleft lip nose deformity have been developed. Inspite of the development it appears that no one procedure has achieved satisfactory results. In addition, the appropriate timing for surgical correction still remains unsettled. The philtrum plays a keyhole in the appearance of the upper lip and nostril sill. But the formation of philtrum with muscle flap or conchal cartilage have been resulted in a unsatisfactory aesthetic outcome. We performed 26 cases of the correction of unilateral cleft lip nose deformity between May 1993 and September 1996, and we always used autogenous palmaris longus tendon for reconstruction of philtral column and nostril sill augmentation. Palmaris longus tendon creates a more definite philtral unit comparing to other materials which have been used and it is easy to harvest and transfer and it does not affect normal function of the hand. And we followed up all patients and confirmed that disappearance of newly formed philtrum is rare. In conclusion, this study shows that autogenous palmaris longus tendon is a useful material for reconstruction of philtral column.
Cartilage ; Cleft Lip* ; Congenital Abnormalities* ; Hand ; Humans ; Lip ; Nose* ; Tendons*

STUDY DESIGN: Clinical and radiographic results of spine fracutre treated with pedicle screws and hooks were reviewed. OBJECTIVES: Evaluate the efficacy of tile pedicle screw and hook for thoracolumar bursting fracture. SUMMARY OF LITERATURE REVIEW: Despite of the mechanical advantage of the pedicle screw, the metal failure in short segment fusion has been reported. A biomechanical study showed additional laminar hook increased rotational strength. MATERIALS AND METHODS: Between 1994 and 1996, seventeen patients who had a Denis type B bursting fracture of the thoracolumbar spine were treated by posterior instrumentation with pedicle screws and laminar hooks and auterior interbody fusion after partial corpectomy. They have been followed for an average of 13.4 months. RESULTS: At last follow-up, radiographs showed successful fusion of the injured spinal segment in all patient. The subsidence of grafts which were used In anterior interbody fusion was an average of 0.76mm. There was a loss of 2.6 degrees on average in the correction of the kyphosis. No patients had screw breakage or loosening. CONCLUSIONS: We concluded that posterior fixation with screws and hooks, anterior decompression by partial corpectomy, and strut-grafting in patient who had a Denis type B bursting frafture of the thoracolumbar spine yielded good radiographic and functional results.
Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Spine* ; Transplants

No abstract available.

Pseudoaneurysm of splenic artery may arise from a vascular erosion by the inflammatory processes around the splenic artery, particularly in acute pancreatitis and chronic pancreatitis, which may cause rupture of pseudoaneurysm and life threatening hemorrhage. Collective experience with this massive hemorrhage is attended by a high mortality rate even with prompt therapy, and conservative management is associated with an almost 100 per cent of mortality rate. Identification of the bleeding site at laparotomy may be exceedingly difficult, which makes the preoperative detection of bleeding source desirable. Peripancreatic vascular lesions can be identified by angiography, and in selected cases the risk of urgent operation to control massive hemorrhage may be obviated by embolization. The authors have recently experienced a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography were essential to confirm these complications of pancreatic pseudocyst. We managed this child successfully with an urgent procedure of transcatheter arterial embolization and another elective surgery of pancreatic pseudocyst.
Aneurysm, False* ; Angiography ; Child* ; Hemorrhage ; Humans ; Laparotomy ; Male ; Mortality ; Pancreatic Pseudocyst ; Pancreatitis ; Pancreatitis, Chronic ; Rupture ; Splenic Artery* ; Tomography, X-Ray Computed

We reviewed the medical records of the 65 patients with stage 1 macular holes and evaluated the effect of prophylactic vitrectomy (34 patients)compared with observation only (31 patients).Mean follow up period was 38.2 and 27.7 months, respectively.88.3%of the patients of the vitrectomy group, and 87.1%of the patients of the observation group showed improved or same visual acuity.Postoperative complications were noted in 35.3%of the vitrectomy group, and lens nuclear sclerosis was the most frequent postoperative complication.Progression of stage 1 macular holes to the higher stage hole was noted in 5.9%of vitrectomy group, and 9.6%of the observation group.There was no statistical significance between two groups.And the prognosis of stage 1 macular hole is thought to be favorable.
Follow-Up Studies ; Humans ; Medical Records ; Prognosis ; Retinal Perforations* ; Sclerosis ; Vitrectomy*

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks' gestation by ultra- sonography, so present the case and the review with literature briefly.
Congenital Abnormalities ; Ectopia Cordis* ; Heart ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Thorax

STUDY DESIGN: Retrospective study. OBJECTIVES: To demonstrate the fusion rate, degree of subsidence and donor site morbidity of anterior cervical interbody fusion with autogenous bicortical iliac bone graft and anterior cervical locking plate. SUMMARY OF THE LITERATURE REVIEW: In anterior cervical discectomy and fusion with autogenous tricortical iliac bone graft, a large percentage of patients report chronic donor site pain. MATERIALS AND METHODS: Retrospective research was done for 39 patients who underwent anterior cervical interbody fusion with autogenous bicortical iliac bone graft, from January 2006 to July 2011, with a follow up period of longer than 1 year. Fusion rates and subsidece of the graft is estimated with radiographs. Neck pain and donor site pain was estimated with visual analogue scale (VAS) and dysfunction was estimated with the neck disability index (NDI). RESULTS: A 95% of patients who underwent anterior cervical interbody fusion with autogenous bicortical iliac bone graft revealed definitive fusion with little amount of subsidence. The mean VAS score was 0.7 on the donor site and the mean NDI score was 3.8 at the final visit. There was excellent clinical outcome without complication at the donor site or the recipient site. CONCLUSIONS: Anterior cervical interbody fusion with autogenous bicortical iliac bone graft showed high fusion rates and minimal subsidence with excellent clinical outcomes. Therefore, bicortical iliac bone graft is an effective operational procedure in anterior cervical interbody fusion.
Diskectomy ; Follow-Up Studies ; Humans ; Neck ; Neck Pain ; Retrospective Studies ; Tissue Donors ; Transplants

PURPOSE: This study was conducted to determine whether a learning curve is necessary to obtain a successful total mesorectal excision (TME) for mid or low rectal cancer. METHODS: We retrospectively reviewed the records of 80 patients that underwent a total mesorectal excision for mid or low rectal cancer between 1994 and 1998 and between 1999 and 2002. We compared the results between the two period groups. Endpoints were postoperative urological functions and the local recurrence rate. RESULTS: There was no significant difference for age, gender, tumor differentiation and stage between patients in the two groups. Local recurrence (LR) developed in 23% of patients in the early group and 7.5% of patients in the late group. The cumulative LR risk at 60 months was 27.5% for the early period group and 9.9% for the late period group (P=0.082) and the difference between the two groups was significant for TNM III stage (29.8% vs. 9.8%, P=0.049). Postoperative urological complications were not significantly different between the two groups (P=0.75). CONCLUSION: Based on these results, TME seemed to require a learning curve. In clinical trials for rectal cancer surgery, the learning curve for qualified surgery from the standpoint of oncological outcome should be considered to minimize bias due to surgeon-associated factors. A more broad application of the TME concept to a larger number of patients with mid or low rectal cancer is warranted.
Bias (Epidemiology) ; Humans ; Learning ; Learning Curve ; Rectal Neoplasms ; Recurrence ; Retrospective Studies

PURPOSE: The use of barium enemas to confirm the anastomotic integrity prior to ileostomy closure is still controversial. The purpose of the study was to determine the utility of routine contrast enema prior to ileostomy closure and its impact on patient management in patients with a low pelvic anastomosis. METHODS: One hundred forty-five patients had a temporary loop ileostomy constructed to protect a low colorectal or coloanal anastomosis following low anterior resection for rectal cancer. All patients were evaluated by physical examination, proctoscopy, and barium enema prior to ileostomy closure. RESULTS: The median time from ileostomy creation to closure was 8 months. Five (3.5%) of the 144 patients were found to have clinically relevant strictures at the colorectal anastomosis on routine barium enema. One patient (0.7%) showed anastomotic leak on their barium enema. Overall, 141 patients (97.9%) had an uncomplicated postoperative course. Postoperative complication occurred in three patients (2.1%). None of them showed abnormal barium enema finding, which suggested that routine contrast enema examination did not predict postoperative complication. CONCLUSION: Routine barium enema evaluation of low pelvic anastomoses before loop ileostomy closure did not provide any additional information for postoperative colorectal anastomotic complication.
Anastomotic Leak ; Barium ; Constriction, Pathologic ; Enema ; Humans ; Ileostomy ; Physical Examination ; Postoperative Complications ; Proctoscopy ; Rectal Neoplasms