Iron deficiency has been discussed as an etiologic factor in diffuse alopecia. Although the mechanism of alopecia related to iron deficiency remains unknown, the diagnosis is confirmed if hair loss ceases with iron administration. However, hair structure abnormalities due to iron deficiency are less known. We report a case of hair structure abnormality associated with iron deficiency anaemia. The hair structure abnormality was a fusiform and expanded node of the hair shaft. The hair loss ceased and the abnormality was corrected with iron administration.
Alopecia ; Diagnosis ; Hair* ; Iron*

Open tracheostomy has been indicated for patients who require prolonged mechanical ventilation or respiratory care in order to avoid lots of complications during long-term endotracheal intubation. Because there are a number of disadvantages and serious complications in standard open tracheostomy, a simpler, safe and minimally invasive procedure such as percutaneous dilatational tracheostomy (PDT) and translaryngeal tracheostomy (TLT) were introduced as an appropriate procedure that can be administered at bedside. In terms of prevention of complications, minimal invasive tracheostomy techniques are more advisable for post open heart surgery patients. After two failed attempts at respirator weaning, we experienced a successful TLT for a 71-year-old male patient with intractable post CABG pneumonia post-op 15 days in an intensive care unit. During and post-TLT courses were not eventful. The cannula was removed 2 weeks after TLT and the patient was subsequently discharged to ward.
Aged ; Catheters ; Heart* ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Male ; Pneumonia ; Respiration, Artificial ; Thoracic Surgery* ; Tracheostomy* ; Ventilator Weaning

No abstract available.
Humans ; Infant, Newborn* ; Pneumonia*

No abstract available.
Osteoma

BACKGROUND: Esmolol has been applied to lower myocardial oxygen consumption and creates a quieter operative field by reducing systemic blood pressure and heart rate but can cause a certain amount of hemodynamic instability during minimally invasive direct vision coronary artery bypass graft (MIDCAB). The aim of this study was to compare the hemodynamic differences between two methods; inducing hypotension and bradycardia between esmolol infusion alone, and concomitant use of neostigmine during MIDCAB anesthesia. METHODS: Twenty MIDCAB patients were randomly allocated into two groups, group E (n = 10) receiving esmolol 0.3 mg/kg/min, group EN (n = 10) receiving esmolol 0.2 mg/kg/min and neostigmine 1.0 mg for induced hypotension and bradycardia during coronary anastomosis. The hemodynamic parameters were evaluated 10 minutes after induction of anesthesia (T1), 10 minutes after beginning of operation (T2), 5 minutes before the end of anastomosis (T3) and 10 minutes after the end of anastomosis (T4). Data were analyzed by ANOVA test for intragroup comparisons, and by T-test for intergroup comparisons with significance set at a P value of < 0.05. RESULTS: Heart rate significantly decreased at T3 in both groups and more in group EN. Systolic blood pressure decreased at T3 in both groups and there were no group differences but more episodes of extreme hypotension in group E. The cardiac index significantly decreased at T3 in both groups and more in group E. There was a small but significant increase in pulmonary capillary wedge pressure at T3 and T4 in group E and no change of central venous pressure in both groups. CONCLUSION: Concomitant use of neostigmine during esmolol infusion produces more reliable induced hypotension and bradycardia than esmolol infusion alone for MIDCAB anesthesia in terms of prevention of myocardial ischemia and easiness of anastomosis technique.
Anesthesia* ; Blood Pressure ; Bradycardia* ; Central Venous Pressure ; Coronary Artery Bypass ; Heart Rate ; Hemodynamics ; Humans ; Hypotension* ; Myocardial Ischemia ; Neostigmine* ; Oxygen Consumption ; Pulmonary Wedge Pressure ; Transplants

BACKGROUND: The purpose of this study was to evaluate the efficacy of suction drain use following arthroscopic rotator cuff repair by comparing early pain score and range of motion (ROM) between groups with and without suction drains. METHODS: The study included 153 patients with rotator cuff tears who underwent arthroscopic repairs at our clinic from April 2014 to March 2015. Following surgery, a suction drain was used in 85 patients (group D) and not used in 68 patients (group ND). There was no statistical difference between the groups in terms of age, gender, or total operation time. The clinical outcome with regard to pain (assessed by pain scores and analgesic requests) and passive ROM was assessed preoperatively and postoperatively. RESULTS: Immediate postoperative analgesic requirement was significantly higher in group D (p=0.001), although there was no difference in pain outcomes between the groups during the 3-month follow-up period. A statistically significant difference in passive ROM was observed at the postoperative 2- and 6-week follow-ups (p=0.036, 0.035, and 0.034 in forward elevation (FE), external rotation at the side (ER) and 90 ER at weeks 2, respectively; 0.045 and 0.009 in FE and ER at weeks 6, respectively); however no significant difference was observed at the end of 3 months. During the study period, no complication was reported in either group. CONCLUSIONS: Use of suction drains after arthroscopic rotator cuff repair provided little benefit in terms of ROM or pain in the early postoperative period (up to 3 months).
Arthroscopy ; Follow-Up Studies ; Humans ; Postoperative Period ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder ; Suction* ; Tears

BACKGROUND: Although herpes zoster primarily affects afferent sensory neurons, it may complicated by motor nerve involvement in 0.5% to 5% of cases. However herpes zoster-induced muscle paresis is still under-recognized by dermatologists, and there has been insufficient clinical investigation of these conditions. OBJECTIVE: This study was conducted to investigate the clinical aspects of motor nerve involvement of herpes zoster. METHODS: We retrospectively reviewed the data of 711 patients with herpes zoster who had been admitted to our hospital in the departments of dermatology, ophthalmology, otorhinolaryngology, neurology, neurosurgery and rehabilitation medicine between 2005 and 2010. RESULTS: Among the 711 patients with herpes zoster, 15 patients had motor paresis (2.1%). 11 patients (73.3%) had facial nerve palsy including one patient who had accompanying vagus nerve palsy. Besides, one case of trochlear nerve palsy, one case of hypoglossal nerve palsy, one case of upper limb paresis and one case of lower limb paresis were noted. Associated underlying diseases were observed in nine patients (60.0%). Duration of motor weakness ranged from 1 month to 4 years. Twelve patients (80.0%) achieved complete recovery. CONCLUSION: In our patient population, the incidence of motor involvement of herpes zoster was higher in cranial nerves, especially the facial nerve, than in spinal nerves. Although motor nerves are usually involved in relation to dermatome, cranial nerve palsy may occur regardless of its dermatome because of complicated anatomical association. The majority of cases recovered completely without any complications. Further prospective investigation with a large group of patients is necessary to better understand the epidemiology of motor nerve involvement of herpes zoster.
Cranial Nerve Diseases ; Cranial Nerves ; Dermatology ; Facial Nerve ; Herpes Zoster ; Humans ; Hypoglossal Nerve Diseases ; Incidence ; Lower Extremity ; Neurology ; Neurosurgery ; Ophthalmology ; Otolaryngology ; Paralysis ; Paresis ; Retrospective Studies ; Sensory Receptor Cells ; Spinal Nerves ; Trochlear Nerve Diseases ; Upper Extremity ; Vagus Nerve

No abstract available.
Neurocutaneous Syndromes*

No abstract available.
Neurocutaneous Syndromes*

No abstract available.
Fistula ; Neck* ; Salivary Glands*