No abstract available.
Constriction, Pathologic* ; Decompression* ; Laminectomy*

No abstract available.
Occupations

PURPOSE: To determine the efficacy and safety of the in situ anterior vaginal wall sling procedure for the treatment of anatomical incontinence (AI) and intrinsic sphincter dysfunction (ISD). MATERIALS AND METHODS: A total of 53 women (31 with AI and 22 with ISD), having undergone in situ anterior vaginal wall sling procedures, were reviewed. The preoperative evaluation included a detailed history taking, physical examination and urodynamic study, including Valsalva leak point pressure (VLPP) and incontinence staging, with Stamey grade. The efficacy and clinical outcome of this procedure were accessed by telephone interviews. RESULTS: With a mean follow up of 30.8 months (24-52), 49 (92.5%) of the 53 patients were completely continent or improved. The success rate of AI and ISD patients were 93.5 and 90.9% respectively. One patient (1.9%) required a prolonged Foley catheter drainage of up to 2 weeks. Sixteen (84.2%) out of the 19 patients with preoperative urge incontinence improved postoperatively, and de novo urge incontinence developed in 1 patient (1.9%). Postoperative wound infections developed in 3 patients (5.7%). CONCLUSIONS: The in situ anterior vaginal wall sling procedure can be an effective and safe surgical treatment option in both AI and ISD patients.
Catheters ; Drainage ; Female ; Follow-Up Studies ; Humans ; Interviews as Topic ; Physical Examination ; Surgical Wound Infection ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge ; Urodynamics

PURPOSE: The purpose of this study is to evaluate the clinical features that necessitate a temporary stoma for the treatment of colonoscopic perforations. RESULTS: Between January 2000 and July 2006, 30 patients were treated for colonoscopic perforation. Based on the perforation sites, we classified these patients into the following groups: proximal colon, sigmoid colon, and rectum; we then reviewed clinical data, including the time to operation and management. RESULTS: Seventeen patients had a perforation during the diagnostic colonoscopy. Of these patients, 14 patients had sigmoid colon perforation. Six underwent an operation within 10 hours after perforation. Of these six, four were managed by primary repair or resection with anastomosis, one sigmoid colon cancer patient by anterior resection, and one rectal cancer patient by low anterior resection with diverting ileostomy. Eight patients underwent more than 12 hours after perforation. Of these eight, three were managed by resection with anastomosis and diverting ileostomy and five by resection with end colostomy. Thirteen patients had a perforation during the therapeutic colonoscopy. Of these patients, 10 patients had a proximal colon perforation. Of these 10, 3 without fever or peritonitis symptom were managed by conservative management, 6 by primary repair or resection with anastomosis, and 1 transverse colon cancer patient by right hemicolectomy. Three patients had sigmoid colon perforation. Of these three, one was managed by primary repair, one by resection with anastomosis, and one sigmoid colon cancer patient by anterior resection. CONCLUSIONS: The mechanism of perforation, the site of the perforation, and the time to operation are associated with intraperitoneal contamination and have an influence on surgical treatment.
Colon ; Colon, Sigmoid ; Colon, Transverse ; Colonoscopy ; Colostomy ; Fever ; Humans ; Ileostomy ; Peritonitis ; Rectal Neoplasms ; Rectum ; Sigmoid Neoplasms

Rheumatoid vasculitis usually occurs in patients with long standing, seropositive, erosive rheumatoid arthritis. It involves typically small to medium-sized vessels and is associated with peripheral neuropathy, digital gangrene, nail fold infarcts, livedo reticularis, and palpable purpura. Histologic examination of skin biopsy specimens usually shows leukocytoclastic vasculitis. We report a case of rheumatoid vasculitis developed on both extremities in a 63-year-old female with rheumatoid arthritis for 15 years.
Arthritis, Rheumatoid ; Biopsy ; Extremities ; Female ; Gangrene ; Humans ; Livedo Reticularis ; Middle Aged ; Peripheral Nervous System Diseases ; Purpura ; Rheumatoid Vasculitis* ; Skin ; Vasculitis

Primary cutaneous cryptococcosis (PCC) is a localized skin infection confined to one body region, without evidence of dissemination. The clinical presentation of PCC is so variable that its diagnosis requires a high index of suspicion. A 52-year-old woman presented with localized grouped erythematous papulovesicles on the left ear lobe for 6 months with wax and wane pattern. However, there were no signs of systemic cryptococcal infection. Histopathological examination showed numerous encapsulated round spores and budding yeasts in the dermis. Culture of aspirate from the wound and tissue samples revealed Cryptococcus neoformans. Herein, we report an interesting case of PCC on the left ear that clinically mimics herpes zoster.
Body Regions ; Cryptococcosis ; Cryptococcus neoformans ; Dermis ; Ear ; Female ; Herpes Zoster ; Humans ; Saccharomycetales ; Skin ; Spores

BACKGROUND: The role of extended-spectrum beta-lactamase (ESBL)-producing or multidrug-resistant (MDR) organisms in patients with sepsis secondary to urinary traction infection (UTI) has not been investigated extensively in the intensive care unit (ICU) setting. METHODS: Patients with UTI sepsis admitted to the ICU were retrospectively enrolled in this study (January 2009-December 2012). We investigated the impact of ESBL-producing and ESBL-negative MDR organisms on hospital outcome. RESULTS: In total, 94 patients were enrolled (median age, 73.0 years; female, 81.9%), and ESBL-producing and ESBL-negative MDR organisms accounted for 20.2% (n = 19) and 30.9% (n = 29), respectively. Both patients with ESBL-producing and ESBL-negative MDR organisms were more likely to experience a delay in adequate antibiotic therapy than those with non-ESBL/non-MDR organisms (p < 0.001 and p = 0.032, respectively). However, only patients with ESBL-producing organisms showed a higher mortality rate (ESBL vs. ESBL-negative MDR vs. non-ESBL/non-MDR, 31.6% vs. 10.3%.vs. 10.9%, respectively). In multivariate analyses, ESBL production was significantly associated with hospital mortality (odds ratio, 11.547; 95micro confidence interval, 1.047-127.373), and prior admission was a significant predictor of ESBL production. CONCLUSIONS: Although both ESBL-producing and ESBL-negative MDR organisms are associated with delayed administration of appropriate antibiotics, only ESBL production is a significant predictor of hospital mortality among patients with UTI sepsis in the ICU setting.
Anti-Bacterial Agents ; beta-Lactamases* ; Drug Resistance, Multiple* ; Female ; Hospital Mortality ; Humans ; Intensive Care Units* ; Mortality ; Multivariate Analysis ; Retrospective Studies ; Sepsis* ; Urinary Tract ; Urinary Tract Infections

PURPOSE:This study was undertaken to investigate the prevalence and the risk factors of thrombocytopenia in children taking valproate for convulsive disorders. METHODS:From Jan. 2000 to Dec. 2005, we reviewed the medical recordes of 54 children with convulsive disorders taking valproate over a period of 12 months. Then, we estimated the prevalence of thrombocytopenia, and analyzed the relationship between changes in platelet counts and other factors such as age, sex, serum valproate levels and the duration of valproate therapy. RESULTS:Six(11.1%) children taking valproate had at least one episode of thrombocytopenia. The platelet counts were significantly lowered at 3 months after valproate therapy and recovered after 6 months(P<0.05). The relationship between the platelet counts and other factors such as blood valproate levels, sex and age was not observed in our study. CONCLUSION:Thrombocytopenia can appear after a few months of therapy and regular monitorings of platelet counts in children taking valproate may be needed to prevent potential bleeding diathesis.
Child* ; Disease Susceptibility ; Hemorrhage ; Humans ; Medical Records ; Platelet Count ; Prevalence* ; Risk Factors* ; Thrombocytopenia* ; Valproic Acid*

The benefits of radio-chemotherapy in HIV-negative primary central nervous system (CNS) lymphomas were analyzed in 40 patients, who received radiotherapy to the brain or craniospinal axis with the total dose of 4460-5940 cGy to the primary tumor. Radiotherapy was followed by systemic chemotherapy, mainly with the cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) regimen, in 16 of the patients. Follow-up ranged from four to 95 months with a median of 15 months. The relapse rate was 72.5%, and 83% of the relapses occurred within the radiation field. Median survival was 19 months and the two-year survival rate was 41%. Survival was significantly influenced by treatment method and radiation dose when measured by univariate analysis; median survival and the two-year survival rate was 29 months and 63% after radio-chemotherapy, while 13.5 month and 29% after radiotherapy alone (p= 0.027), and 22 months and 49% with doses of 50 Gy or more, but 12.5 months and 13% with doses less than 50 Gy (p=0.009). However, statistical significance was lost in multivariate analysis. These results might suggest the short-term efficacy of radio-chemotherapy, however, cautious observation is needed to confirm long-term effects.
Adolescence ; Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use* ; Antineoplastic Agents, Combined/adverse effects ; Bleomycin/administration & dosage ; Central Nervous System Neoplasms/therapy* ; Central Nervous System Neoplasms/mortality ; Cyclophosphamide/administration & dosage ; Disease-Free Survival ; Doxorubicin/administration & dosage ; Epirubicin/administration & dosage ; Female ; Human ; Lymphoma/therapy* ; Lymphoma/mortality ; Male ; Mechlorethamine/administration & dosage ; Methotrexate/administration & dosage ; Middle Age ; Neoplasm Recurrence, Local ; Prednisolone/administration & dosage ; Procarbazine/administration & dosage ; Radiotherapy Dosage ; Radiotherapy, Adjuvant/adverse effects ; Survival Rate ; Treatment Failure ; Vincristine/administration & dosage

Dentigerous cysts are common odontogenic cysts that are associated with the crown of the tooth and typically develop from single lesions. Bilateral and multiple dentigerous cysts are very rare and occur in patients with syndromic conditions. This paper presents a case report of a 15-year-old male patient that experienced non-syndromic bilateral dentigerous cysts that simultaneously occurred in all four dental quadrants around the unerupted third molars. Clinicians should confirm the extent of cystic lesions using a panoramic view and computed tomography, and should keep the possibility of bilateral dentigerous cysts in mind as a potential diagnosis, even in a non-syndromic patient.
Adolescent ; Crowns ; Dentigerous Cyst* ; Diagnosis ; Humans ; Male ; Molar, Third ; Odontogenic Cysts ; Tooth