Dupuytren's contracture is caused by a proliferative fibroplasia of the subcutaneous palmar tissue. It is most common in those of Scandinavian and Celtic origin, although it has rarely been reported in Orientals. Many types of surgery are advocated, all with apparent success. Then operative result of 23 cases of Dupuytren's contracture including seven bilateral involvment was analyzed partial fasciectomy was performed in all cases by one surgeon. Average follow-up period was 18 months. We analyzed the results of the operation, to Honner s classification. Excellent result was obtained in 6 cases(26%), good in 14(61%) fair in 3(13%), and poor in 0(0%). The complication were 8(34%) case as followshematoma 4(17%), stiffness 3(13%), skin necrnsis 1(4%). All patrents were not performed that skin graft and total fasciectomy. The partial fasciectomy is suggested as one of the successful method for the treatment of Dupuytren's contracture.
Classification ; Clinical Study ; Dupuytren Contracture ; Follow-Up Studies ; Methods ; Skin ; Transplants

Postoperative epidural hematoma (EDH) usually present with neurological deficit. Massive EDH presenting with only severe pain without neurological deficit are rare. Atypical presentations of postoperative EDHs may lead to delayed diagnosis and treatment. We present three such cases after posterior cervical spine surgery. Three patients presented with severe neck pain and spasms without motor deficits several days after posterior cervical decompressive procedures. Imaging studies identified compressive EDHs at the surgical site with severe compression of the spinal cord. All were treated with emergent decompression, with resulting improvement of symptoms and pain relief without further neurological sequelae. In conclusion, postoperative EDHs after posterior cervical spine surgery may result in minimal neurological deficit. Our report reminds surgeons to keep this possibility in mind when patients complain of unusually severe neck pain and spasms after posterior cervical spine surgery.
Decompression ; Delayed Diagnosis ; Hematoma* ; Humans ; Neck Pain* ; Neck* ; Postoperative Complications ; Spasm ; Spinal Cord ; Spine*

Purpose: Patients with coronavirus disease 2019 (COVID-19) should be isolated from others to prevent widespread infection. The purpose of this study was to evaluate the feasibility of performing peripherally inserted central catheter (PICC) placement in patients with COVID-19 isolated in the intensive care unit (ICU) of a small volume center hospital. Methods: This retrospective study included 79 patients who underwent PICC in 2 ICUs. There were 41 patients with COVID-19 who were isolated in an ICU (isolated ICU) and there were 38 patients who required ICU care who did not have COVID-19 (non-isolated ICU). Their medical records including PICC-related complications and clinical variables were compared. Results: PICC placement was performed to maintain long-term intravenous access for 78% of the COVID-19 group and 52.6% of the non-COVID-19 group (p = 0.017). The mean procedure time (minutes) was 15.2 ± 7.58 in the COVID-19 group and 12.6 ± 6.65 in the non-COVID-19 group (p = 0.109). When PICC tip locations were divided into three groups (optimal, suboptimal, and malpositioned), there was no significant difference between the two groups of patients. PICC-related complications in COVID-19 and non-COVID-19 groups included non-functioning catheter (0% vs. 5.3%, p = 0.137), occurrence of swelling or hematoma around PICC inserted site (2.4% vs. 0%, p = 0.333), and PICC-related infection. Conclusion PICC placement for patients with COVID-19 isolated in the ICU of a small volume center hospital was feasible and safe.

BACKGROUND AND PURPOSE: Neuropathological studies have demonstrated that multiple system atrophy (MSA) produces selective atrophy of the putamen with sparing of the caudate nucleus, while both structures are spared in idiopathic Parkinson's disease (PD). In this study we evaluated the clinical efficacy of using putaminal atrophy in brain MRI to differentiate MSA and PD. METHODS: We measured the putamen/caudate volume ratio on brain MRI in 24 patients with MSA and 21 patients with PD. Two clinicians who were blinded to the patients' diagnoses and to each other's assessments measured the volume ratio using a computer program. RESULTS: The measured volume ratios of the two investigators were highly correlated (r=0.72, p<0.0001). The volume ratio was significantly lower in MSA (1.29+/-0.28) than PD (1.91+/-0.29, p<0.0001). Setting an arbitrary cutoff ratio of 1.6 resulted in about 90% of patients with MSA falling into the group with a lower ratio, whereas more than 80% of patients with PD belonged to the other group. CONCLUSIONS: The present results demonstrate that putaminal atrophy in MSA as measured on brain MRI represents an effective tool for differentiating MSA from PD.
Atrophy ; Brain ; Caudate Nucleus ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Multiple System Atrophy* ; Parkinson Disease* ; Putamen ; Research Personnel

Interleukin-7 (IL-7) is known as a growth factor for pre B-cell and mature T-cells in human. But in leukemic cells, IL-7 effect is variously reported. To investigate the effect of IL-7 on the cells of childhood acute leukemia we used 3H-Thymidine assay. Twelve Acute lymphoblastic leukemia (ALL), seven T-ALL and three Acute myelogenous leukemia (AML) were involved in this study. Two out of twelve ALL and three out of seven T-ALL bone marrow (BM) cells were stimulated by IL-7 in 3H-Thymidine incorporation. In normal and AML BM cells, IL-7 had no stimulatory activity as in various leukemic cell lines. Two normal peripheral blood T-cells responded to IL-7 dose dependently. We have seen the effect of IL-7 to stimulate T-lineage cells but, for precise conclusion, further study using more purified samples will be needed.
Adolescent ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Female ; Humans ; Infant ; Interleukin-4/pharmacology ; Interleukin-7/*pharmacology ; Leukemia, Myeloid, Acute/*immunology ; Leukemia-Lymphoma, Adult T-Cell/*immunology ; Lymphocytes/drug effects/*immunology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*immunology ; Tumor Cells, Cultured

INTRODUCTIONMyopes are suspected to be poorer at responding to accommodative stimuli than emmetropes, and this may worsen the degree of their myopia. The study aims to compare the abilities of young adult emmetropes and myopes in responding to accommodative stimuli, as indicated by their Accommodation Stimulus Response Curves (ASRCs) in a predominantly Chinese population.

MATERIALS AND METHODSSeventeen emmetropes and 33 myopes aged between 16 and 23 years (mean, 18.6 +/- 1.2) were recruited, of whom 11 were progressing and 22 were non-progressing myopes. The ASRC gradients of subjects were measured using the methods of decreasing distance series (DDS), positive (PLS) and negative lens series (NLS).

RESULTSThe ASRC is method dependent. The gradients of the curves are significantly different among 3 methods of measurement using single-factor ANOVA (F3.057 = 44.815, P <0.01). The slopes of the accommodative errors of all subjects were steeper using the NLS method, and the lags of accommodation increased with elevated demands. No significant differences in ASRC gradients were found between emmetropes, non-progressing myopes and progressing myopes for the range of accommodative demands for each method. Progressing myopes showed the highest error towards the higher demand compared with the emmetropes and non-progressing myopes.

CONCLUSIONAccommodative responses of myopes were more sluggish though there were no statistical differences in ASRC gradients between emmetropes and myopes. It is not certain if the poorer accommodative responses were a cause, or a consequence, of myopia.

Accommodation, Ocular ; Adolescent ; Adult ; Disease Progression ; Female ; Humans ; Male ; Myopia ; physiopathology ; Refraction, Ocular

INTRODUCTIONWe present a series of head and neck extracranial non-vestibular schwannomas treated during a ten-year period, assessing epidemiology, presenting signs and symptoms, location, nerve of origin, diagnostic modalities, treatment and clinical outcome.

MATERIALS AND METHODSClinical records of all patients with head and neck schwannomas treated at our department from April 1995 to July 2005 were retrospectively reviewed.

RESULTSThere was female predominance (67%). The mean age at diagnosis was 48 years. Sixteen (76%) presented with a unilateral neck mass. Eleven schwannomas (52%) were in the parapharyngeal space. The most common nerves of origin were the vagus and the cervical sympathetic chain. The tumour may masquerade as a cervical lymph node and other myriad conditions. Treatment for all but 2 cases was complete excision with nerve preservation. Two cases of facial schwannoma required sacrifice of the affected nerve portion with nerve reconstruction. All facial schwannoma patients suffered postoperative facial palsy with only partial resolution (mean final House-Brackman grade, 3.25/6). Among non-facial schwannoma patients, postoperative neural deficit occurred in 12 with partial to complete resolution in 7. The median follow-up period was 24 months. No schwannoma was malignant and none recurred.

CONCLUSIONNon-vestibular extracranial head and neck schwannomas most frequently present as an innocuous longstanding unilateral parapharyngeal neck mass. Preoperative diagnosis may be aided by fine-needle cytology and magnetic resonance imaging or computed tomographic imaging. The mainstay of treatment is complete intracapsular excision preserving the nerve of origin, but for extensive tumour or facial schwannomas, subtotal resection or nerve sacrifice with reconstruction and rehabilitation are considerations. Surgery on intraparotid facial schwannomas carries considerable morbidity and conservative management has a place in treatment. Early recognition of facial schwannomas is key to optimal treatment.

Adult ; Aged ; Female ; Head and Neck Neoplasms ; diagnosis ; epidemiology ; pathology ; therapy ; Hospitals, General ; Humans ; Male ; Medical Audit ; Middle Aged ; Neurilemmoma ; diagnosis ; epidemiology ; pathology ; therapy ; Outcome Assessment (Health Care) ; Retrospective Studies ; Risk Factors ; Singapore ; epidemiology ; Time Factors

OBJECTIVES: To compare results of 4 different extraction methods in laparoscopic management of dermoid cyst. STUDY DESIGN: This article is a retrospective, multicenter study for 247 patients with benign dermoid cyst in period of 1995-1998. Dermoid cyst was extracted by Endopouch (99 cases), puncture-irrigation-extraction (69 cases), colpotomy (35 cases), and dermoid cyst as a "pouch bag" (44 cases). RESULTS: We analyzed irrigation amount, operative time, postoperative hospital stay and complications by four different extraction methods. Endopouch extraction method needed less amount of irrigation fluid for cleaning the abdominal cavity and had a shorter postoperative hospital stay (ANOVA, p=0.0001). There were no significant differences in operative times among groups. There were four cases of morbidity in puncture-irrigation-extraction method (6%), three had fever (> 38degrees C) and one intraabdominal abscess. One incisional hernia was noted in "pouch bag" method (2%). CONCLUSIONS: We recommend minimal spillage method for extraction of dermoid and careful irrigation of abdominal cavity to prevent potential risk of chemical peritonitis such as Endopouch, "pouch bag", and colpotomy with the exception of puncture-irrigation-extraction method.
Abdominal Cavity ; Abscess ; Colpotomy ; Dermoid Cyst* ; Fever ; Hernia ; Humans ; Laparoscopy* ; Length of Stay ; Operative Time ; Peritonitis ; Retrospective Studies*

During experimental Eimeria infections in chickens, facilities are often contaminated by fecal oocysts known to be highly resistant to both chemical and enzymatic treatments. Thus, studies using experimental Eimeria infections have been limited due to the difficulty of complete elimination of residual oocysts from both cages and facilities. To overcome this limitation, simple, inexpensive, and disposable cages were constructed from cardboard boxes and tested during experimental Eimeria maxima infections. The cages were used in animal rooms with only a 1.7% evidence of coccidia contamination between adjacent cages. No significant differences in fecal oocyst output and body weight gain were noted between animals housed in disposable cages and animals housed in wire control cages. This cage design is a useful means for preventing oocyst contamination during experimental conditions, suggesting that this disposable cage design could be used for other avian infectious disease studies.
Animals ; Chickens ; Coccidiosis/transmission/*veterinary ; Disposable Equipment/*utilization ; Eimeria/*isolation & purification ; *Environmental Microbiology

Blastic natural killer (NK) cell lymphoma is a rare neoplasm characterized by blastoid tumor cells expressing CD4 and CD56, with predominant skin involvement. Although this tumor has been regarded as a neoplasm related to NK cell, recent studies suggested that it is derived from plasmacytoid dendritic cells, but not from NK cell. Herein we report 4 cases of CD4+CD56+ lineage marker- blastic NK cell lymphomas with a review of literatures. The patients were 3 men and one woman. Three of them were young (17, 18, and 22 yr old). Three patients had skin lesions, at initial presentation in two patients and during the course of disease in other patient. Histologically, tumors consisted of monotonous medium to large blastoid cells showing no necrosis, angiocentric growth or epidermotrophism. All four tumors were CD4+ and CD56+. Three expressed CD68 antigen. Lineage specific markers for B- and T cell were negative. All tumors did not express myeloperoxidase. T-cell receptor gene rearrangement, EBV, CD13 and CD33 were negative. In one patient, tumor cells arranged in Homer-Wright type pseudorosette and expressed terminal deoxynucleotidyl transferase(TdT). Despite the standard lymphoma chemotherapy, the tumors, except one lost during follow-up, progressed and relapsed. The patients died 8-60 months after diagnosis.
Adolescent ; Antigens, CD4/*analysis ; Antigens, CD56/*analysis ; Cell Lineage ; Female ; Humans ; Killer Cells, Natural/immunology/*pathology ; Lymphoma, T-Cell/immunology/*pathology ; Male ; Middle Aged