No abstract available.
Humans ; Infant, Newborn*

No abstract available.

Gougerost-Blum syndrome is a rare disease and characterized by lichenoid papules in association with purpuric lesions. So far as we know there has been no report of, in literatures, Gougerot-Blum syndrome with leukemia. We experienced a case of typical Gougerrot_Blum syndrome with acute myeloblastic leukemia in a 30 year-old female patient. This patient complained of rashes on whole body for 2 months, and frequent epistaxis and gum bleeding for 20 days. The skin revealed miliary to rice sized rusty colored lichenoid papules on whole body especially on legs and arms. Histopathologically the skin showed the picture of Gougerot-Blum syndrome. On peripheral blood examination and bone marrow aspiration myeloblastic leukemia was confirmed. The patient was treated with 6-mercaptopurine, cytoxan and prednisolone with slight improvement of skin lesions, but no improvement of leukumia itselt.
6-Mercaptopurine ; Adult ; Arm ; Bone Marrow ; Cyclophosphamide ; Epistaxis ; Exanthema ; Female ; Gingiva ; Granulocyte Precursor Cells ; Hemorrhage ; Humans ; Leg ; Leukemia* ; Leukemia, Myeloid, Acute ; Prednisolone ; Rare Diseases ; Skin

No abstract available.
Temporomandibular Joint*

No abstract available.
Temporomandibular Joint*

Joints ; Mandible ; Maxilla ; Orthognathic Surgery ; Recurrence ; Skull

No abstract available.
Child* ; Edema* ; Gallbladder* ; Humans

BACKGROUND: Many physicians hesitate to discuss do-not-resuscitate (DNR) orders with patients or family members in critical situations. In the intensive care unit (ICU), delayed DNR decisions could cause unintentional cardiopulmonary resuscitation, patient distress, and substantial cost. We investigated whether the timing of DNR designation affects patient outcome in the medical ICU. METHODS: We enrolled retrospective patients with written DNR orders in a medical ICU (13 bed) from June 1, 2014 to May 31, 2015. The patients were divided into two groups: early DNR patients for whom DNR orders were implemented within 48 h of ICU admission, and late DNR patients for whom DNR orders were implemented more than 48 h after ICU admission. RESULTS: Herein, 354 patients were admitted to the medical ICU and among them, 80 (22.6%) patients had requested DNR orders. Of these patients, 37 (46.3%) had designated DNR orders within 48 hours of ICU admission and 43 (53.7%) patients had designated DNR orders more than 48 hours after ICU admission. Compared with early DNR patients, late DNR patients tended to withhold or withdraw life-sustaining management (18.9% vs. 37.2%, p = 0.072). DNR consent forms were signed by family members instead of the patients. Septic shock was the most common cause of medical ICU admission in both the early and late DNR patients (54.1% vs. 37.2%, p = 0.131). There was no difference in in-hospital mortality (83.8% vs. 81.4%, p = 0.779). Late DNR patients had longer ICU stays than early DNR patients (7.4 ± 8.1 vs. 19.7 ± 19.2, p < 0.001). CONCLUSIONS: Clinical outcomes are not influenced by the time of DNR designation in the medical ICU. The late DNR group is associated with a longer length of ICU stay and a tendency of withholding or withdrawing life-sustaining treatment. However, further studies are needed to clarify the guideline for end-of-life care in critically ill patients.
Advance Directives ; Cardiopulmonary Resuscitation ; Consent Forms ; Critical Illness* ; Hospital Mortality ; Humans ; Intensive Care Units ; Resuscitation Orders* ; Retrospective Studies ; Shock, Septic

No abstract available.
Ileum*

We report herein our surgical experience of Hartmann's procedure reversal using laparoscopic technique in a 72-year-old woman who underwent Hartmann's procedure for an obstructing sigmoid colon cancer 6 month earlier. The purposes of this report are to describe our technique of laparoscopic reversal of Hartmann's procedure, to introduce several technical tips in avoiding pitfalls, and to review its safty and efficacy. In brief, the colostomy was freed from the abdominal wall using a conventional technique, then a center rod and an anvil of a circular stapler were inserted into the colon. CO2 insufflation was performed through this insertion. Using a five-cannula technique, rectal stump was mobilized, then colorectal anastomosis was performed laparoscopically via a transanal stapled approach. The operating time was 130 minutes and blood loss was 50 ml. There were no intra- and postoperative complications. Up to now, with a 4-month follow-up period, the patient has been well without having any problems associated with this operation
Abdominal Wall ; Aged ; Colon ; Colostomy ; Female ; Follow-Up Studies ; Humans ; Insufflation ; Laparoscopy ; Postoperative Complications ; Sigmoid Neoplasms