Patients with severe acetabular bony deficiency in total hip revision arthroplasties need the use of autogenous or allogenic bone grafts. The Authors performed 28 cases of total hip revision arthroplasties between June 1991 and January 1995 with femoral head allograft for acetabular bony deficiencies and evaluated the clinical and radiological results according to AAOS classification. The clinical result was evaluated by D'Aubigne and Postel score. The mean score was improved from 3.9 points to 5.1 points at follow-up. In radiological evaluation, osseous union of graft was achieved within 12 month and rerevision were performed in two cases (92.8% survival rates) but radiological radiolucent line in at least one zone was seen in five hips in two year follow up. In conclusion, the results of hemispherical microporocoat cup with allogenic bone in segmental or cavitary defect using with acetabular reinforcement ring in combined deficiency were encouraging to date. Success rate of allograft reconsruction of the acetabulum results from a variety of acetabular defect. In our studies, only 40% showed stable bony fixation over short period.
Acetabulum* ; Allografts ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Classification ; Follow-Up Studies ; Head ; Hip ; Humans ; Transplants*

Rectovagianl fistula(RVF) is a congenital or acquired communication between the two epithelial-lined surface of the rectum and the vagina. We present our experience with 62 patients with RVF. There were various etiologies and repair methods of rectovaginal fistula. The purpose of this study was to retospectively review the clinical course of the patients we treated and to evaluate the efficacy of various treatment options. The mean age was 40.5 yr, The type of RVF was classified to one of two(simple and complex), according to their location, size and etiology. RVF was developed most commonly after radiotherapy due to cervical cancer(n=17), then after pelvic surgery due to malignancy(n=16), obstetric trauma after episiotomy at delivery(n=7), congenital malformation(n=4), inflammatory bowel disease(n=1), Bechet's disease(n=1), infections such as perianal fistula or abscess(n=2), direct invasion of carcinoma(n=3), after chemotherapy(n=1), and idiopathic(n=6). Three cases of them associated with rectovesicovaginal fistula. Surgical therapeutic option was divided to local repair, abdominal approach and tissue transposition by the type of RVF. Most simple RVFs were repaired with local approach through the vagina or rectum. Most complex RVFs were repaired through abdominal approach or tissue transposition. With an average follow up of 20 months, the treatment results were as follows: completely healed(n=36, 58.1%), persistent symptom(n=6, 9.7%), recurrence after repair(n=5, 8.1%), loss of search or death(n=15, 24.1%). Therefore we assist that the management of RVF depends on size, location, and cause. anal sphincter function and overall health status of the patient. Careful preoperative assessment of the fistula, surrounding tissues, and anal sphincter and exclusion of associated disease are essential. With through evaluation, thoughtful consideration of treatment options, and meticulous operative technique, patient can be assured of an optimal outcome.
Anal Canal ; Episiotomy ; Female ; Fistula ; Follow-Up Studies ; Humans ; Radiotherapy ; Rectovaginal Fistula* ; Rectum ; Recurrence ; Vagina

PURPOSE: The purpose was to evaluate the procedure-related complications of the TIPS and its clinical significance. MATERIALS AND METHODS: The materials consisted of 52 patients who had 57 TIPS procedures for the management of variceal bleeding due to portal hypertension. To detect the occurrence of complications during transhepatic needle puncture(from hepatic vein to the portal vein), contrast material was injected with the withdrawl of the puncture needle. RESULTS: Procedure-related complications occurred in 28 patients (54%) among 52 patients. The corn lications were biliary tree puncture(15 cases), transperitoneal puncture(14 cases), stent malposition(3 cases) stent migration(1 case), hepatic arteries puncture(1 case), splenic vein perforation(1 case), and paroxysmal tricular tachycardia(1 case). Three patients had acute stent thrombosis with rebleeding immediately after procedure. The procedure was repeated in two patients. One patient was expired due to rebleeding. CONCLUSION: The procedure related complications were clinically insignificant in most instances, when stent thrombosis or proxysmal ventricular tachycardia was developed.
Biliary Tract ; Esophageal and Gastric Varices ; Hepatic Artery ; Hepatic Veins ; Humans ; Hypertension, Portal ; Needles ; Portasystemic Shunt, Surgical* ; Punctures ; Splenic Vein ; Stents ; Tachycardia, Ventricular ; Thrombosis ; Zea mays

No abstract available.
Listeria monocytogenes* ; Listeria* ; Macrophages* ; Salmonella typhimurium* ; Salmonella*

No abstract available.
Magnetic Resonance Imaging* ; Tuberculosis, Spinal*

No abstract available.
Intercellular Adhesion Molecule-1* ; Interleukin-6* ; Keratinocytes*

No abstract available.

Children with SARS-CoV-2 infection typically exhibit mild respiratory symptoms, with only a small proportion presenting with gastrointestinal symptoms. However, children and adolescents with cancer may develop severe illnesses when infected with respiratory viruses. Most patients are asymptomatic or have mild-to-moderate infections, but a significant percentage face severe or critical COVID-19-related illnesses. Diagnosing SARS-CoV-2 in pediatric patients is challenging because of frequent asymptomatic cases or those presenting with only a fever. In pediatric patients with SARS-CoV-2, heightened inflammatory markers and coagulation abnormalities are common. Increased levels of inflammatory markers and lymphopenia are risk factors for severe illness, making essential blood tests crucial as potential indicators of disease severity. Febrile neutropenia (FN), a common and potentially fatal side effect of chemotherapy, occurs in roughly 50% of children receiving cancer chemotherapy, and individuals with FN should remain vigilant for SARS-CoV-2 infection, even with mild symptoms. COVID-19-related fatalities occur in 4% of pediatric patients, which is significantly lower than the 25% observed in adult cancer patients but disproportionately higher than the 0.5% mortality rate among general pediatric cohorts.The case of a 12-year-old boy with neutropenic fever undergoing intensive anticancer therapy who was later confirmed to have SARS-CoV-2 infection highlights the importance of vigilance in such patients.

Immune thrombocytopenia (ITP) is characterized by a low platelet count caused by immune-mediated platelet destruction. In children, ITP usually resolves on its own within three months, but treatment may be necessary in some cases. Beta-thalassemia (BT) is an inherited anemia caused by a deficiency in beta-globin protein chain synthesis, and its prevalence is increasing worldwide. Anemia is the most critical symptom, and its severity varies from mild to severe. Patients with BT typically have normal white blood cell (WBC) and platelet counts; however, in some cases, they may experience thrombocytosis or thromboembolic events. Thrombocytopenia is rare in patients with BT; however, some cases of ITP and BT co-occurrence have been reported in patients with thrombotic thrombocytopenic purpura (TTP). This report describes the case of a five-year-old girl diagnosed with BT who presented with immune thrombocytopenia and received rituximab.

Antiphospholipid syndrome (APS) is an autoimmune, multisystemic disorder marked by arterial, venous, or small-vessel thromboembolic events and persistence of antiphospholipid antibodies (aPL). Approximately 50% of APS patients exhibit primary disease features, while the remainder present with concurrent systemic autoimmune conditions. Venous thromboses are more common than arterial thromboses, with the latter primarily developing within the cerebral arteries, as in transient ischemic attacks or strokes. The incidence of thrombosis is higher in cases of APS with systemic lupus erythematosus than in primary APS. Thrombocytopenia, observed in 20-40% of APS patients, is generally moderate, asymptomatic, and does not require intervention. Thrombosis may be linked to autoimmune hemolysis, both of which are associated with aPL. Triple positivity, a high-risk serological profile, including lupus erythematosus, anti-cardiolipin antibodies, and anti-B2 glycoprotein I antibodies, is related to aPL. Positive results for all three serologic tests significantly increase thrombosis risk, necessitating continuous aspirin and warfarin use to mitigate risk.We here report a case involving a 15-year-old girl with triple-positive APS who underwent unsuccessful thrombolysis and balloon catheter dilation procedures and required long-term arterial thrombosis treatment with aspirin and warfarin.