No abstract available.

No abstract available.
Kasabach-Merritt Syndrome*

No abstract available.
Stevens-Johnson Syndrome*

The central venous cannulation is commonly performed in the operating rooms and intensive care units for various purposes. Although the central venous catheter (CVC) is used in many ways, the malpositioning of the CVC is often associated with serious complications. We report a case of an unexpected malposition of a CVC in the jugular venous arch via external jugular vein.
Catheterization ; Central Venous Catheters* ; Intensive Care Units ; Jugular Veins* ; Operating Rooms

PURPOSE: Reported incidence of urinary incontinence after a radical prostatectomy (RP) varies between studies. This may be due not only to the definition of incontinence applied, but also how the information is acquired. We investigated the differences in perception of post robot-assisted laparoscopic RP (RALP) urinary incontinence acquired through doctor interviews and patient-reported questionnaires. MATERIALS AND METHODS: Of 238 consecutive men who underwent RALP by a single surgeon between July 2005 and February 2008, we evaluated 66 men using the International Consultation on Incontinence Questionnaire (ICIQ) at various time points after surgery. Each patient's ICIQ results were considered to be the patient's perceptions of urinary incontinence. The physician at the same time directly interviewed the patients about the number of pads used and considered complete continence to be equivalent to the use of no pads or safety liners. RESULTS: Of the 66 patients, the physician reported that 34 (51.5%) had obtained complete continence. However, analysis of the questionnaires of these 34 patients revealed that only 5 (14.7%) patients reported that they never leaked during the past 4 weeks. Most patients (11 patients, 32.4%) who did not use any pad did in fact reported leakage of a small or moderate amount of urine about once a day. CONCLUSION: Our results indicate that there are discrepancies in the perception of urinary incontinence between doctor and patient after RALP. Non-use of pads is not equivalent to obtaining complete urinary continence. Therefore, the number of pads used is not a good measure to determine the status of complete urinary continence.
Aged ; Aged, 80 and over ; Biopsy ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Perception ; Physician-Patient Relations ; Prostatectomy/*adverse effects/methods ; Questionnaires ; Robotics ; Treatment Outcome ; Urinary Incontinence/*etiology

No abstract available.
Dilatation* ; Urethra*

BACKGROUND: Fine-needle aspiration cytology serves as a safe, economical tool in evaluating thyroid nodules. However, about 30% of the samples are categorized as indeterminate. Hence, many immunocytochemistry markers have been studied, but there has not been a single outstanding marker. We studied the efficacy of CD56 with human bone marrow endothelial cell marker-1 (HBME-1) in diagnosis in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) category III. METHODS: We reviewed ThinPrep liquid-based cytology (LBC) samples with Papanicolaou stain from July 1 to December 31, 2016 (2,195 cases) and selected TBSRTC category III cases (n = 363). Twenty-six cases were histologically confirmed as benign (six cases, 23%) or malignant (20 cases, 77%); we stained 26 LBC slides with HBME-1 and CD56 through the cell transfer method. For evaluation of reactivity of immunocytochemistry, we chose atypical follicular cell clusters. RESULTS: CD56 was not reactive in 18 of 20 cases (90%) of malignant nodules and showed cytoplasmic positivity in five of six cases (83%) of benign nodules. CD56 showed high sensitivity (90.0%) and relatively low specificity (83.3%) in detecting malignancy (p = .004). HBME-1 was reactive in 17 of 20 cases (85%) of malignant nodules and was not reactive in five of six cases (83%) of benign nodules. HBME-1 showed slightly lower sensitivity (85.0%) than CD56. The specificity in detecting malignancy by HBME-1 was similar to that of CD56 (83.3%, p = .008). CD56 and HBME-1 tests combined showed lower sensitivity (75.0% vs 90%) and higher specificity (93.8% vs 83.3%) in detecting malignancy compared to using CD56 alone. CONCLUSIONS: Using CD56 alone showed relatively low specificity despite high sensitivity for detecting malignancy. Combining CD56 with HBME-1 could increase the specificity. Thus, we suggest that CD56 could be a useful preoperative marker for differential diagnosis of TBSRTC category III samples.
Biopsy, Fine-Needle ; Bone Marrow ; Cytoplasm ; Diagnosis ; Diagnosis, Differential ; Endothelial Cells ; Humans ; Immunohistochemistry ; Methods ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Nodule

Objective To evaluate the application value of the new chinese diabetes risk score in the clinical diagnosis of type 2 diabetes mellitus.Methods A total of 232 subjects who received physical examination at the outpatient department of endocrinology were selected.Medical history and demographic information were collected.Physical examination and 75 g oral glucose tolerance test (OGTT)were conducted.Fasting or 2 -h blood glucose,HbA1 c,serum triglyceride (TG), total cholesterol (TC)and low density lipoprotein cholesterol (LDL-C)were measured.Results The area under the receiver operating curve was 0. 788 (95%CI=0. 725 -0. 852),with 0. 832 (95%CI=0. 748 -0. 916)in males and 0. 754 (95%CI=0. 664-0. 844)in females.At the optimal cutoff value (25 scores)for detecting type 2 diabetes,the sensitivity was 88. 06%and the specificity was 37. 58%.The Diabetes Risk Score was positively related to the probability of type 2 diabetes.Conclusion The new chinese diabetes risk score could be a reliable screening tool to evaluate undiagnosed type 2 diabetes in the Chinese population.

Objective: To compare the diagnostic accuracy of dilatation and curettage (D&C) versus endometrial aspiration biopsy in follow-up evaluation of patients treated with progestin for endometrial hyperplasia (EH) Methods: A prospective multicenter study was conducted from 2015 to 2018. Patients with EH were treated with progestin, one of the following three treatment regimens: oral medroxyprogesterone acetate (MPA) 10 mg/day for 14 days per cycle, continuous MPA 10 mg/day or the levonorgestrel-releasing intrauterine system (LNG-IUS). At 3 or 6 months of treatment, endometrial tissues were obtained via 2 methods in each patient: aspiration biopsy, followed by D&C. The primary outcome was the consistency of the histologic results between the 2 methods. The secondary outcome was the regression rate at 6 months of treatment. Results: The study population comprised 65 patients (55 with non-atypical hyperplasia, 10 with atypical hyperplasia). During the follow-up, a comparison of the pathologic results from aspiration biopsy and D&C was carried out for the 65 cases. Thirty-eight cases were diagnosed as EH by D&C. Among these, only 24 were diagnosed with EH from aspiration biopsy, for a diagnostic concordance of 63.2% (ĸ=0.59). Forty-four patients were followed up at 6 months, and the regression rate was 31.8% (14/44). Responses were obtained for 41.7% (5/12) of the cyclic MPA group, 58.3% (7/12) of the continuous MPA group and 10% (2/20) of the LNG-IUS group. Conclusion As a follow-up evaluation of patients treated with progestin for EH, aspiration biopsy is less accurate than D&C and might not be a reliable method.

Gastritis cystica polyposa is an uncommon lesion that usually occurs at the gastroenterostomy site, but it may also develop in the non-operated stomach. This malady is characterized by polypoid mucosal changes with hyperplasia and cystic dilatation of glands that infiltrate into the submucosal layer. We report here on a case of gastritis cystica polyposa that presented as a mass impacted in the duodenum in a 63-year-old male, and this patient had been admitted for evaluation of progressive epigastric fullness and dyspepsia. Esophagogastroduodenoscopy revealed that the partial duodenal obstruction was caused by impaction of a huge polypoid mass with a stalk that originated from the lower body of the stomach. We fished out the impacted mass with a forceps catheter while holding the neck with a snare catheter. Thereafter, an endoloop was applied to the stalk of mass, and this was followed by polypectomy using a snare catheter.
Catheters ; Dilatation ; Duodenal Obstruction ; Duodenum ; Dyspepsia ; Endoscopy, Digestive System ; Gastritis ; Gastroenterostomy ; Humans ; Hyperplasia ; Male ; Middle Aged ; Neck ; SNARE Proteins ; Stomach ; Surgical Instruments