No abstract available.
Humans ; Hypersensitivity* ; Skin*

A 30-year-old male was involved in a car accident. Radiographs revealed a depressed marginal fracture of the medial tibial plateau and an avulsion fracture of the fibular head. Magnetic resonance imaging showed avulsion fracture of Gerdy's tubercle, injury to the posterior cruciate ligament (PCL), posterior horn of the medial meniscus, and the attachments of the lateral collateral ligament and the biceps femoris tendon. The depressed fracture of the medial tibial plateau was elevated and stabilized using a cannulated screw and washer. The injured lateral and posterolateral corner (PLC) structures were repaired and augmented by PLC reconstruction. However, the avulsion fracture of Gerdy's tubercle was not fixed because it was minimally displaced and the torn PCL was also not repaired or reconstructed. We present a unique case of pure varus injury to the knee joint. This case contributes to our understanding of the mechanism of knee injury and provides insight regarding appropriate treatment plans for this type of injury.
Adult ; Fibula/*injuries/surgery ; Humans ; *Knee Injuries/complications/surgery ; Male ; *Multiple Trauma/complications/surgery ; *Tibial Fractures/complications/surgery

To evaluate the implication of vascular factors in normal tension glaucoma, the authors measured ocular blood flow velocity in normal tension glaucoma patients using Doppler Ultrasound. Seventeen consecutive patients(29 eyes) of normal tension glaucoma were studied. The peak systolic and diastolic velocities of ophthalmic artery in normal tension glaucoma were 25.48 +/- 4.09cm/sec and 5.48 +/- 1.16cm/sec, respectively; there were statistically significant decrease of blood flow velocities compared to those of primary open angle glaucoma(30.83 +/- 5.38cm/sec, 9.10 +/- 3.25cm/sec)(p<0.05) and normal group(38.12 +/- 6.42cm/sec, 9.77 +/- 2.64cm/sec)(p<0.05). The peak systolic and diastolic velocities of central retinal artery in normal tension glaucoma were 5.95 +/- 1.05cm/sec and 2.14 +/- 0.83cm/sec, respectively; there was statistically no significant decrease of blood flow velocities compared to those of normal group and primary open angle glaucoma group. Above results imply that the blood flow velocity of ophthalmic artery decrease significantly in normal tension glaucoma and local vascular factors are somewhat related to the development of the normal tension glaucoma. Further studies are necessary to validate these preliminary findings.
Blood Flow Velocity* ; Glaucoma, Open-Angle ; Humans ; Low Tension Glaucoma* ; Ophthalmic Artery ; Retinal Artery ; Ultrasonography*

PURPOSE: To evaluate the impact of a retrotrigonal layer backup stitch (RTBS) during robot-assisted laparoscopic radical prostatectomy (RALP) on post-prostatectomy incontinence. MATERIALS AND METHODS: We compared the difference in continence recovery between 94 patients (group 1, as historical controls) and 57 patients (group 2). The only technical difference between our two groups was the incorporation of the retrotrigonal layer into the posterior aspect of the vesicourethral anastomosis (group 1: without RTBS; group 2: with RTBS). Postoperative continence recovery was defined as the use of no absorbent pads. RESULTS: In group 1, the continence rate at 3, 6, and 12 months postoperatively was 40.4%, 70.2%, and 90.4%, respectively;in group 2, the continence rate was 42.1%, 70.1%, and 89.7%, respectively. The median (95% confidence interval) time to continence recovery was four months (range, 1 to 12 months) in group 1 and four months (range, 1 to 9 months) in group 2. Kaplan-Meier curves showed no significant difference in the recovery of continence between the two groups (log rank test, p=0.629). CONCLUSIONS: A RTBS does not appear to improve urinary incontinence after RALP. Further anatomical study and prospective randomized studies will be needed to confirm this.
Humans ; Prostatectomy ; Prostatic Neoplasms ; Urinary Incontinence

Pigmented villonodular synovitis (PVNS) is a rare proliferative disease affecting joint synovium, tendon sheaths, bursae. The usual treatment for PVNS is a surgical excision. If destructive joint lesions have occurred, complete resections must be performed followed by arthrodesis or arthroplasty. We report a case of a pigmented villonodular synovitis involving an ankle joint which was treated by total ankle replacement for recurrence after simple synovectomy.
Animals ; Ankle ; Ankle Joint ; Arthrodesis ; Arthroplasty ; Arthroplasty, Replacement, Ankle ; Joints ; Recurrence ; Synovial Membrane ; Synovitis, Pigmented Villonodular ; Tendons

Tinea barbae is a dermatophyte infection of the bearded areas of the face and neck. The incidence of tinea barbae has decreased as improved sanitation. We report a case of tinea barbae in a 49-year-old-man, who presented with relatively well-defined erythematous patch with pustules on the upper lip. A fungal culture from tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical Trichophyton mentagrophytes. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of Arthroderma vanbreuseghemii IHEM 4411. The patient was treated with oral itraconazole for 3 months. The skin lesions improved 3 months after treatment, and recurrence has not been observed.
Agar ; Arthrodermataceae ; Base Sequence ; Glucose ; Humans ; Incidence ; Itraconazole ; Lip ; Neck ; Recurrence ; Sanitation ; Skin ; Tinea* ; Trichophyton*

Renin-Angiotensin system (RAS) has been suggested as one of important factors in stress-related responses, and also suggested to be a pro-oxidant in mammals. Studies about antioxidant activity changes in brain by systemic administration of angiotensin II (Ang II) may be valuable data in the clarification of pathogenesis and development of treatment modalities for the psychologic stress-induced somatic disease, such as stress-induced hypertension. We examined, therefore, antioxidant defense changes in the brain induced by Ang II. Antioxidant enzyme activities including superoxide dismutase (SOD), contents of glutathione (GSH), and lipoperoxidation (LPO) were measured in the dissected specimens of the brain regions after subcutaneous injection of human Ang II. In this study, peripheral administration of Ang II decreased LPO in the cerebral cortex, hippocampus, striatum, hypothalamus of Sprague-Dawley rats. Ang II increased activities of SOD, glutathione peroxidase, and glutathione reductase in the hippocampus and striatum. Borderline-hypertensive rats (BHR), a well-known animal model for stress-induced hypertension, showed some differences in the Ang II-induced antioxidant activity changes, comparing with SD rats. In the BHR, peripheral administration of Ang II significantly decreased the activities of antioxidant enzymes and contents of GSH, increased LPO contents in the various regions of brain. These results suggested that oxidative stress on the brain due to Ang II may be greater in the BHR than SDs, and RAS may be one of important pathophysiologic factors for stress-induced hypertension in BHR.
Angiotensin II ; Animals ; Brain* ; Cerebral Cortex ; Glutathione ; Glutathione Peroxidase ; Glutathione Reductase ; Hippocampus ; Humans ; Hypertension ; Hypothalamus ; Injections, Subcutaneous ; Mammals ; Models, Animal ; Oxidative Stress ; Rats* ; Rats, Sprague-Dawley ; Renin-Angiotensin System ; Superoxide Dismutase

In 22 end-stage renal disease patients on regular hemodialysis, echocardiographic study including 2-D Doppler echocardiogrphy was performed to evaluate the effect of hemodialysis on cardiac performance and the degree of valvular regurgitation. After hemodialysis, there were significant improvement of ventricular contractility and reduction of circulating volume in accordance with the reduction of degree of valvular regurgitation in comparison with before hemodialysis. We postulate that the reduction of valvular regurgitation after hemodialysis is caused by relief of hypervolemic state.
Echocardiography* ; Echocardiography, Doppler ; Humans ; Kidney Failure, Chronic ; Renal Dialysis*

Lower urinary tract dysfunction-such as urinary incontinence (UI), detrusor overactivity, and benign prostatic hyperplasia-is prevalent in elderly persons. These conditions can interfere with daily life and normal functioning and lead to negative effects on health-related quality of life. UI is one of the most common urologic conditions but is poorly understood elderly persons. The overall prevalence of UI increases with age in both men and women. Elderly persons often neglect UI or dismiss it as part of the normal aging process. However, UI can have significant negative effects on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. Although UI is more common in elderly than in younger persons, it should not be considered a normal part of aging. UI is abnormal at any age. The goal of this review is to provide an overview of the cause, classification, evaluation, and management of geriatric lower urinary tract dysfunction.
Activities of Daily Living ; Aged ; *Aging/physiology/psychology ; Disease Management ; Female ; Humans ; Male ; Prevalence ; *Quality of Life ; Urinary Tract/*physiopathology ; *Urologic Diseases/classification/epidemiology/etiology/physiopathology/psychology/therapy

OBJECTIVE: The authors present their experiences with stereotactic multiplanar reformatted (MPR) computed tomography (CT)-guided catheter placement for thrombolysis of spontaneous intracerebral hematoma (sICH) and their clinical results. METHODS: In 23 patients with sICH, MPR CT-guided catheter placement was used to select the trajectory and target point of hematoma drainage. This group was comprised of 11 men and 12 women, and the mean age was 57.5 years (range, 31-79 years). The patients' initial Glasgow Coma Scale scores ranged from 7 to 15 with a median of 11. The volume of the hematoma ranged from 24 mL to 86 mL (mean 44.5 mL). A trajectory along the main axis of the hematoma was considered to be optimal for thrombolytic therapy. The trajectory was calculated from the point of entry through the target point of the hematoma using reformatted images. RESULTS: The hematoma catheter was left in place for a median duration of 48.9 hours (range 34 to 62 hours). In an average of two days, the average residual hematoma volume was 6.2 mL (range 1.4 mL to 10.2 mL) and was reduced by an average of 84.7% (range 71.6% to 96.3%). The residual hematoma at postoperative seven days was less than 5 mL in all patients. There was no treatment-related death during hospitalization. CONCLUSION: The present study indicates that stereotactic MPR CT-guided catheter placement for thrombolysis is an accurate and safe procedure. We suggest that this procedure for stereotactic removal of sICH should be considered for the optimization of the trajectory selection in the future.
Axis, Cervical Vertebra ; Catheters ; Drainage ; Female ; Glasgow Coma Scale ; Hematoma ; Hospitalization ; Humans ; Hypogonadism ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Thrombolytic Therapy