Nineteen patients suffering from post-traumatic intracerebral hematoma, being managed by stereotactic aspiration of hematoma were evaluated. The outcome in this series is quite satisfactory, with 58% of patients having a functional survival. Eight patients died, of which three patients died of brain swelling and 5 died of systemic causes such as respiratory failure, gastrointestinal(GI) bleeding, and renal failure. It is our belief that stereotactic aspiration is helpful in managing patients with traumatic intracerebral hematoma without herniation and wevere brain swelling.
Brain Edema ; Hematoma* ; Hemorrhage ; Humans ; Renal Insufficiency ; Respiratory Insufficiency

There exist some restrictions and difficulties in performing follicular unit extraction (FUE) in white-haired patients, for several reasons. In this paper, we introduce a novel technique for visualizing white hair during the punching procedure and graft preparation in FUE for white-haired patients. In white-haired older male patients, we dyed the surrounding scalp skin purple with a gentian violet solution-stained toothpick. Our method has several advantages: surgeons can easily focus on the center of the follicular unit and rapidly perform punching, they can recognize the condition of the harvested follicular units during FUE, and the hair transplant team can secure a clear view for trimming and loading into the implanter. We suggest that scalp dyeing in difficult FUE procedures, especially in patients with white hair, may be a simple method that provides a good visualization for donor site harvesting and for microdissection.
Alopecia ; Gentian Violet* ; Gentiana* ; Hair ; Hair Color ; Humans ; Male ; Methods ; Microdissection ; Scalp ; Skin ; Surgeons ; Tissue Donors ; Transplants

Very late stent thrombosis after implantation of drug eluting stent is rare, but its consequences are potentially fatal. Stent thrombosis may be occurred in perioperative period because of interruption of anticoagulation therapy and intraoperative hypercoagulability. We report a case of very late stent thrombosis in a 49-year-old male patient during total gastrectomy. ST-segment elevation in lead II occurred during the surgery and followed by cardiac arrest. After external cardiac massage and electrocardioversion, normal sinus rhythm was restored. Postoperative 12 lead ECG showed ST-segment elevation in leads II, III, aVF and serum cardiac enzymes such as CPK, CK-MB, and Troponin T were markedly elevated. Postoperative coronary angiography showed complete occlusion of the right coronary artery stent. Emergency percutaneous transluminal coronary angioplasty was performed and the patient recovered uneventfully.
Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Emergencies ; Gastrectomy ; Heart Arrest ; Heart Massage ; Humans ; Male ; Middle Aged ; Perioperative Period ; Stents ; Thrombophilia ; Thrombosis ; Troponin T

The fine structure of cells in the trigeminal mesencephalic (Me5) nucleus in the rat was studied by transmission electron microscopy. This nucleus located in the mid-brain and the rostral portion of the pons, most neurons in the caudal part of Me5 nucleus were sufficiently large (40~50micrometer) and appeared as round-shaped unipolar cells. The Me5 neurons had a large, round, centrally located nucleus, and their cytoplasm contained numerous mitochondria, dense granular endoplasmic reticulum, abundant Golgi apparatus, groups of free ribosomes, some heterogeneous particles and neurofilaments. Cell surfaces were studded irregularly with small spinouts processes, and they contained a few fine irregularly arranged neurofilaments and some granular endoplasmic reticulum. Boutons contacting the soma of Me5 neurons were defined as axosomatic synapses and bostons contacting dendrites located between the Me5 neurons were defined as axodendritic synapses. Based on differences in bouton and vesicle morphology, the four synaptic bouton types were identified. 1. Asymmetrical as well as symmetrical synapses with small round vesicles. 2. Asymmetrical synapses with pleomorphic admixture contained predominantlyspherical vesicles. 3. Symmetrical synapses with pleomorphic vesicles of flattened, spherical and dense-core vesicles. 4. Asymmetrical as well as symmetrical synapses with heterogeneous and large dense-core vesicles. Synaptic boutons containing round vesicles and large dense-core vesicles were most frequently observed.
Animals ; Carisoprodol ; Cytoplasm ; Dendrites ; Endoplasmic Reticulum, Rough ; Golgi Apparatus ; Microscopy, Electron, Transmission ; Mitochondria ; Neurons ; Pons ; Presynaptic Terminals ; Rats* ; Ribosomes ; Synapses

PURPOSE: To report the clinical outcomes of percutaneous A1 pulley release for the surgical treatment of locked trigger thumb in children. MATERIALS AND METHODS: Twenty-six trigger thumbs in 24 patients with a average of 14.2 months follow-up after percutaneous release were enrolled. There were 15 females and 9 males with an average age of 39 months. The mean time from first presentation to surgery was 16 months. Procedures were performed under local anesthesia. Postoperative examinations at immediate, 3 months and 1-year recorded pain, triggering and range of motion and presence of complications. RESULTS: All thumbs had a satisfactory result without digital nerve injury. Eleven patients(46%) had a mean 14.3degrees extension loss of the interphalangeal joint and 12.0degrees hyperextension of the metacarpophalangeal joint of the thumb, compared to the contralateral thumb. At final follow-up, all but 1 patient were completely resolved. The duration of symptoms and age were higher in the group with thumb deformity (p<0.05). CONCLUSION: Temporary thumb deformity is possible after surgical treatment of trigger thumb in children with a long duration of symptoms. Percutaneous release can be a safe and satisfactory treatment option in pediatric trigger thumb.
Anesthesia, Local ; Child ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Hand Deformities ; Humans ; Joints ; Male ; Metacarpophalangeal Joint ; Range of Motion, Articular ; Thumb ; Trigger Finger Disorder

Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure. Acute pyelonephritis without urinary tract obstruction, previous renal diseases or septic shock is a rare cause of acute renal failure. Despite appropriate antibiotic therapy, recovery of renal function could be slow and incomplete. We experienced a 45 year-old woman with diabetes who developed bilateral acute pyelonephritis followed by acute renal failure. The renal biopsy revealed diffuse edematous and focal fibrotic inters- titium with infiltration of lymphocytes compatible with interstitial nephritis. Although her renal function improved gradually with antimicrobial treatment, the process was incomplete and renal dysfunction persisted at about 10-month follow-up, suggesting permanent renal damage. Therefore, we report this case with brief review of related literature.
Acute Kidney Injury* ; Adult ; Biopsy ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Lymphocytes ; Middle Aged ; Nephritis, Interstitial ; Pyelonephritis* ; Shock, Septic ; Urinary Tract ; Urinary Tract Infections

PURPOSE: The purpose of this study was to investigate the etiology of acute pharygotonsillitis in pediatric patients. METHODS: Pharyngeal swabs from patients with acute pharyngotonsillitis were evaluated for viruses and bacterial organisms from March 2010 through March 2011. RESULTS: Of 615 patients, potentially pathogenic bacteria were isolated in 40 (6.5%), viruses were isolated in 310 (50.4%), and no pathogens were isolated in 267 patients (43.4%). Both viral and bacterial pathogens were found in 2 (0.3%). Of 40 patients with bacterial pathogens, group A streptococci were found in 31 (77.5%). Among 310 patients with virus infection, adenovirus was the most frequently recovered (203 patients; 65.5%), followed by rhinovirus (65 patients; 21.0%), enterovirus (43 patients; 13.9%) and coronavirus (18 patients; 5.8%). There were 25 patients who had been coinfected with 2 viruses. In viral pharyngotonsillitis, cough, rhinorrhea, conjunctivitis and diarrhea were prominent. On the other hand, pharyngeal injection and pharyngeal petechiae were prominent in bacterial pharyngotonsillitis. CONCLUSIONS: Virus infection was a big part of acute pharyngotonsillitis and there were differences in clinical manifestations among viral and bacterial infections. Therefore, we need to distinguish between virus infection and bacterial infection using clinical signs for preventing the abuse of antibiotics.
Adenoviridae Infections ; Anti-Bacterial Agents ; Bacteria* ; Bacterial Infections ; Child* ; Conjunctivitis ; Coronavirus ; Cough ; Diarrhea ; Enterovirus ; Hand ; Humans ; Purpura ; Rhinovirus

OBJECTIVES: To analyze factors associated with elderly falls in a community dwelling, a comparatively important, but somewhat neglected, health matter. METHODS: Data came from personal interview surveys using a questionnaire of 552 people aged 65 or older living in a community. Socioeconomic, and health related characteristics were investigated as independent variables and experiences of falling in the previous year as the dependent variable. RESULTS: 118(21.4%) of the elderly subjects experienced a fall in the previous year. 24 subjects experienced more than two falls, accounting for 20.3% of the elderly fall victims studied. Factors affecting the falls were families living together, level of daily activity, heart disease, and aconuresis;, therefore an elderly person who lives alone, lives independently, has heart disease, or suffers urinary incontinence had a demonstrated increased chance of falling. CONCLUSION: Groups at risk for falling included elderly persons living alone, living independently, suffering heart disease, or experiencing urinary incontinence. When an elderly fall prevention program is developed and implemented, these results should be considered.
Accidental Falls ; Aged* ; Heart Diseases ; Humans ; Prevalence* ; Questionnaires ; Urinary Incontinence

Hemangiopericytoma is a rare kind of soft tissue tumor. It usually attacks adults without distinction of sex. In most cases, slowly enlarging mass is a chief complaint of patient and symptoms such as tenderness and pain are rare. It is known to frequently attack the lower extremity, especially thigh, pelvic fossa and retroperitoneum, and in rare cases, trunk and upper extremity. In this paper, we report a 47-ear-old female patient with primary orbital hemangiopericytoma in right upper eyelid. Before operation, we found oval-shaped tumor which had a vivid boundary, from the orbital CT and MRI. During the operation, we found an ovoid mass(about 2.6 X 2 X 1 cm) surrounded by a thin capsule on the upper eyelid medial portion. By H&E stain after operation, we found a "staghorn" configuration- haped blood vessel distribution. In an immunohistochemical stain test using factor VIII-related antigen, this tumor was not originated from endotheliumm, but from vessel. In Gomori's reticulin stain test, we confirmly diagnosed these tumor cells as hemangiopericytoma, since these cells were arranged around the vessel, surrounded by a reticulin fiber. She had no symptom of recurrence after operation. As hemangiopericytoma is not frequently developed in an orbital area, we report this case in this paper.
Adult ; Blood Vessels ; Eyelids ; Female ; Hemangiopericytoma* ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Orbit* ; Recurrence ; Reticulin ; Thigh ; Upper Extremity ; von Willebrand Factor

BACKGROUND: For laparoscopic cholecystectomy, pain is most frequent complaint and the most common cause of delayed discharge. The aim of this study was to determine the effect of preoperative administration of celecoxib on the level of postoperative pain in patient undergoing laparoscopic cholecystectomy. METHODS: We enrolled 60 patients ASA class I and II, scheduled for elective laparoscopic cholecystectomy. The patients were randomized to receive celecoxib 200 mg, celecoxib 400 mg or placebo two hour before the induction of anesthesia. The patients received the same anesthetics. The intensities of abdominal pain were assessed using VAS (visual analog scale) at 1, 2, 4, 12, 24 hours after surgery. RESULTS: In celecoxib 200 mg group, VAS score of somatic pain compared to control group decreased at 1, 2, and 4 hours after surgery. In celecoxib 400 mg group, VAS score of somatic pain compared to control group decreased at 1, 2, and 4 hours after surgery. There was no difference between celecoxib 200 mg and celecoxib 400 mg in pain scores of somatic pain. Dosage of meperidine in two celecoxib groups after surgery were each 31 mg and 26 mg and that of control group was 72 mg. There was no difference between celecoxib groups and placebo group in pain scores of visceral pain. CONCLUSIONS: The preoperative administration of celecoxib reduces the level of postoperative pain after laparoscopic cholecystectomy without adverse effects.
Abdominal Pain ; Anesthesia ; Anesthetics ; Cholecystectomy, Laparoscopic ; Humans ; Meperidine ; Nociceptive Pain ; Pain, Postoperative ; Pyrazoles ; Sulfonamides ; Visceral Pain ; Celecoxib