No abstract available.
Family Practice* ; Humans

Angioleiomyomas are relatively uncommon benign tumors originating from smooth cells of a blood vessel. Although curative by surgical excision, they are rarely diagnosed definitely before surgery. We report on a case of calcified angioleiomyoma occurring on the sole, which was treated by surgical excision without recurrence and a review of literature is presented.
Angiomyoma* ; Blood Vessels ; Foot ; Recurrence

STUDY DESIGN: A case report. OBJECTIVES: To report a case of simultaneous pulmonary and renal embolisms after balloon kyphoplasty and review relevant literature. SUMMARY OF LITERATURE REVIEW: Pulmonary or renal embolism caused by cement leakage during balloon kyphoplasty is a rare complication but can be fatal. MATERIALS AND METHODS: An 84-year-old female patient was treated with balloon kyphoplasty for an osteoporotic compression fracture. Pulmonary and renal embolisms were detected after the procedure and the patient was treated conservatively. RESULTS: After conservative treatment, embolism-related symptoms were not found during the follow-up period. CONCLUSIONS: We encountered a case of simultaneous pulmonary and renal cement embolisms which occurred during kyphoplasty. This is a very rare but potentially serious complication. However, the patient had no long-term sequelae after conservative treatment.
Aged, 80 and over ; Embolism* ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Kyphoplasty* ; Pulmonary Embolism ; Spine

PURPOSE: The routine use of postoperative nasogastric decompression after abdominal surgery has been challenged. Furthermore, investigators have recently shown that early postoperative oral feeding is safe and generally well tolerated. This study was aimed to determine whether or not early postoperative feeding is safe after elective colorectal surgery. METHODS: All patients who underwent elective colorectal surgeries between June 1998 and March 1999 were permitted to take oral intake one day after the operations. The patients were compared with other patients, who had underwent elective colorectal surgeries between September 1997 and June 1998 and permitted to have a meal after resolving postoperative ileus. The nasogastric tube was removed from all patients immediately after surgery. The patients were monitored for the time of ileus resolution, nausea/vomiting, abdominal distension, nasogastric tube reinsertion and complications. RESULTS: Fifty-one patients were studied, 24 patients in early feeding group and 27 patients in traditional feeding group. Eighteen patients (75.0%) in the early feeding group tolerated the early oral intake. There were no significant differences between two groups in the time for resolution of ileus (3.46 1.38 days vs 3.56 1.80 days), nausea/vomiting (33.3% vs 29.6%), abdominal distension (16.6% vs 14.8%) and nasogastric tube reinsertion (12.5% vs 7.4%). No significant difference was noted in complications such as wound infection, pulmonary problems, intestinal obstruction and anastomotic leak. CONCLUSIONS: Early oral intake after elective colorectal surgery was safe and most of the patients tolerated it. And it may become a kind of managements after elective colorectal surgery.
Anastomotic Leak ; Colorectal Surgery* ; Decompression ; Humans ; Ileus ; Intestinal Obstruction ; Meals ; Research Personnel ; Wound Infection

C-reactive protein(CRP), a normal constituent of the serum in healthy individuals, increases in response to various bacterial infections and cellular necrosis. To find out if the C-reactive protein concentration is of any value in the diagnosis of acute appendicitis, ninety consecutive patients suspected to have acute appendicitis were studied prospectively. Of these, 54 patients(group A) had acute appendicitis and 6 patients(group B) underwent surgery with a diagnosis of acute appendicitis; however, histopathology disclosed a normal appendix. Seventeen patients(group C) had no identifiable cause for their illness and 13 patients(group D) had an identifiable cause for their illness, though not appendicitis. The mean serum CRP value was 49.00mg/L in group A, 18.92mg/L in group B, 20.31mg/L in group C, and 63.22mg/L in group D. Within group A, the mean CRP value in the 36 patients with the inflammed appendix was 33.56mg/L. The mean value in the 7 patients with the gangrenous appendix was 73.16mg/L, and 97.61mg/L in 11 patients with the perforative appendix. Serum CRP levels were normal in two patients with acute appendicitis. Besides these 2 patients, all patients with normal CRP had a normal appendix found at the time of operation or their symptoms resolved spontaneously. It is concluded that an increase in CRP levels to more than 5 mg/L is not a definitive indicator of acute appendicitis. However, when there is doubt about the diagnosis of acute appendicitis, a normal serum CRP level should be used as a basis for the decision to defer surgery.
Appendicitis* ; Appendix ; Bacterial Infections ; C-Reactive Protein* ; Diagnosis ; Humans ; Necrosis ; Prospective Studies

The criteria for evaluating permanent impairments resulting from principal dysfunction of the ear, nose, throat, and related structures are uncertain in our country. However, our government is now striving to build up a welfare state with upgrading the law of industrial accident insurance. The author assess permanent impairment ratings of these structures by evaluating losses in structures or the following functions: hearing; equilibrium; respiration; mastication; olfaction, and taste; speech and voice; and the effect of these losses on the ability to perform activities of daily living. Impairment criteria were adapted from the literature, law and ordinances in our country.
Accidents, Occupational ; Activities of Daily Living ; Ear ; Hearing ; Insurance ; Jurisprudence ; Mastication ; Nose ; Otolaryngology* ; Pharynx ; Respiration ; Smell ; Voice

A through knowledge of the anatomy of colonic mesenteric arteries is necessary to accomplish successful, uncomplicated abdominal operations, especially laparoscopic colonic resections in which the mesenteric vessels can't be palpated. Such knowledge is also important when performing a colonic resection for cancer using proximal vascular ligation and wide en bloc resection. Most surgical textbooks depict a "normal pattern" of arterial supply to the right colon as consisting of three arterial branches (the ileocolic, the right colic, and the middle colic arteries) arising independently from the superior mesenteric artery (SMA). Based on the literature, there are only two colonic arteries arising independently from the SMA in many cases. We examined the anatomy of these arteries in 50 patients who had had SMA angiographies for various diseases from January 1995 to May 1997. In all of our cases, the ileocolic artery and the middle colicartery emanated directly from the SMA, but the right colic artery originated directly from the SMA in only 54% of the cases. The right colic artery was absent in 8% of the cases. It also arose as a single trunk with the middle colic artery (22% of the cases) and from the ileocolic artery (16% of the cases). Our data, together with published anatomic studies, lead us to conclude that in many cases there are only two independent branches arising from the SMA that supply the large intestine, the ileocolic artery and the middle colic artery. This knowledge may be helpful in laparoscopic colon surgery, radical colon resections for cancer, and colon replacements after operations on the esophagus or the urinary bladder.
Angiography ; Arteries* ; Colic* ; Colon ; Esophagus ; Humans ; Intestine, Large ; Ligation ; Mesenteric Arteries ; Mesenteric Artery, Superior ; Urinary Bladder

No abstract available.
Brain* ; Emergencies* ; Emergency Service, Hospital* ; Humans

We performed this study to analyse the morbidity and mortality of stoma formation in infants and children over a 17-year period. Thirty-seven stoma formations were performed in 37 patients: 21 for anorectal malformation, 9 for Hirschsprung's disease, 3 for necrotizing enterocolitis, 2 for multiple ileal atresia, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. There were 26 boys and 11 girls with a mean age of 0.4 years. Complications after stoma formation were encountered in 12 patients(32.4%) and included stomal prolapse, stenosis, retraction, dysfunction, skin excoriation and parastomal hernia. Four patients(10.8%) required stomal revision. The incidence of complications was neither related to the age nor to the primary indication for the stoma formation, but sigmoid colostomy was associated with a lower complication rate compared to transverse colostomy(22.1% versus 42.1%, P<0.05). Five patients died, but only one(2.7%) was dead, which was directly related to stoma formation. Eighteen of these children subsequently underwent stoma closure which was associated with complications in six patients(33.3%). The most common complication after stoma closure was wound sepsis in 4 children. In conclusion, because the significant morbidity of stoma formation still exists the refinements in surgical technique may help in reducing the incidence of complications and a sigmoid loop colostomy should be used whenever possible.
Child* ; Colon ; Colon, Sigmoid ; Colostomy ; Constriction, Pathologic ; Enterocolitis, Necrotizing ; Female ; Hernia ; Hernia, Diaphragmatic ; Hirschsprung Disease ; Humans ; Incidence ; Infant* ; Intestinal Volvulus ; Mortality ; Prolapse ; Sepsis ; Skin ; Wounds and Injuries

No abstract available.
Apgar Score* ; Depression* ; Humans ; Psychology*